Individual provider Active NPI

Enoch Walden Williams, MD

  • Urology Physician
  • Jonesboro, AR
National Provider Identifier
1437348745
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
R-2048 Issued in AR
Practice address
3817 S Culberhouse Rd
Jonesboro, AR 72404-9067
Phone
(870) 935-4886
Fax
(870) 933-6334
NPI assigned
Oct 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X R-2048 AR Primary

Addresses

Primary practice location

3817 S Culberhouse Rd
Jonesboro, AR 72404-9067

Mailing address

3817 S Culberhouse Rd
Jonesboro, AR 72404-9067
Phone (870) 935-4886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R-2048ARMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Bernards Urology Associates, Inc. Urology PastSince Aug 31, 2015 Accepting new patients
Medical Plaza Urology Associates Urology PastSince Jun 15, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1437348745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 S CULBERHOUSE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049067",
            "telephone_number": "870-935-4886",
            "fax_number": "870-933-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 S CULBERHOUSE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049067",
            "telephone_number": "870-935-4886",
            "fax_number": "870-933-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ENOCH",
        "middle_name": "WALDEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "R-2048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.