Provider Demographics
NPI:1962874834
Name:WILLIAMS, WILLIAM
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 STATE HIGHWAY 189
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:TN
Mailing Address - Zip Code:38034-4010
Mailing Address - Country:US
Mailing Address - Phone:731-217-5429
Mailing Address - Fax:
Practice Address - Street 1:2156 STATE HIGHWAY 189
Practice Address - Street 2:
Practice Address - City:FRIENDSHIP
Practice Address - State:TN
Practice Address - Zip Code:38034-4010
Practice Address - Country:US
Practice Address - Phone:731-217-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)