Provider Demographics
NPI:1366009169
Name:WILLIAMS, JOHN POWELL IV (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:POWELL
Last Name:WILLIAMS
Suffix:IV
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:200 FORT SANDERS W BLVD
Mailing Address - Street 2:BUILDING 1, SUITE 102
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922
Mailing Address - Country:US
Mailing Address - Phone:865-531-5350
Mailing Address - Fax:865-374-2125
Practice Address - Street 1:200 FORT SANDERS W BLVD
Practice Address - Street 2:BUILDING 1, SUITE 102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-531-5350
Practice Address - Fax:865-374-2125
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2025-11-19
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ053289Medicaid
1162330OtherNATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS