Provider Demographics
NPI:1992986533
Name:WILLIAMS, SHARON E (CO, BOCO, CPED)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CO, BOCO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 E STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-7115
Mailing Address - Country:US
Mailing Address - Phone:423-288-8559
Mailing Address - Fax:423-288-5227
Practice Address - Street 1:3551 E STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-7115
Practice Address - Country:US
Practice Address - Phone:423-288-8559
Practice Address - Fax:423-288-5227
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNORT0000000096222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist