Provider Demographics
NPI:1306895586
Name:DREWRY, WILLIAM RICE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RICE
Last Name:DREWRY
Suffix:
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 1:6005 PARK AVE
Mailing Address - Street 2:728 B
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5202
Mailing Address - Country:US
Mailing Address - Phone:901-685-2311
Mailing Address - Fax:901-761-4062
Practice Address - Street 1:6005 PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5212
Practice Address - Country:US
Practice Address - Phone:901-761-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18711207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN001070522006OtherUNITED HEALTHCARE
5620173OtherAETNA
2389511OtherCIGNA HEALTH CARE
TN4068057OtherBLUE CROSS BLUE SHIELD
TN4068057OtherBLUE CROSS BLUE SHIELD
TN001070522006OtherUNITED HEALTHCARE
2389511OtherCIGNA HEALTH CARE