| Doctor Name: | MR. JASON ANTHONY WILLIAMS |
| NPI Number: | 1609949288 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 102539 |
| Business Practice Address: | 2001 S Main St Suite 200 Wake Forest, NC - 275871612 |
| Business Phone Number: | 9195623155 |
| Business Fax Number: | 9195627401 |
| Mailing Address: | 1010 Clarendon St, FAYETTEVILLE |
| State: | NC |
| Postal Code: | 283054847 |
| Phone Number: | 9102379483 |
| Fax Number: | 9195627401 |
| NPI Enumeration Date: | 11/15/2006 |
| NPI Last Update Date: | 04/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 102539 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |