Provider Demographics
NPI:1215924691
Name:MERWIN, WILLIAM HENSLEY JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HENSLEY
Last Name:MERWIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 WEST POINT DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2833
Mailing Address - Country:US
Mailing Address - Phone:865-777-1727
Mailing Address - Fax:865-966-0942
Practice Address - Street 1:11201 WEST POINT DR
Practice Address - Street 2:SUITE 103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2833
Practice Address - Country:US
Practice Address - Phone:865-777-1727
Practice Address - Fax:865-966-0942
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000020891174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC85511Medicare UPIN