Provider Demographics
NPI:1902062391
Name:WILLIAMS, KENNETH LAMONT (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LAMONT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 292878
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-2878
Mailing Address - Country:US
Mailing Address - Phone:615-579-2772
Mailing Address - Fax:866-577-1809
Practice Address - Street 1:345 COMPTON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-1352
Practice Address - Country:US
Practice Address - Phone:615-579-2772
Practice Address - Fax:615-327-4608
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine