Provider Demographics
NPI:1447259130
Name:WILLIAMS, JOHN SHELDON IV (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SHELDON
Last Name:WILLIAMS
Suffix:IV
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2714
Mailing Address - Country:US
Mailing Address - Phone:520-325-0161
Mailing Address - Fax:520-325-0914
Practice Address - Street 1:2606 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2714
Practice Address - Country:US
Practice Address - Phone:520-325-0161
Practice Address - Fax:520-325-0914
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor