Provider Demographics
NPI:1053173344
Name:WILLIAMS, LONNIE C JR
Entity type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:C
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MUIRWOOD VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-4036
Mailing Address - Country:US
Mailing Address - Phone:740-973-9506
Mailing Address - Fax:
Practice Address - Street 1:140 MUIRWOOD VILLAGE DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4036
Practice Address - Country:US
Practice Address - Phone:740-973-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health