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NPI Code Detail

MEDICARE: DR. GINA MOORE WILLIAMS M.D.

MEDICARE: DR. GINA MOORE WILLIAMS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician41375TN
2208000000XPediatrics Physician41375TN

General Provider Information

NPI Number : 1811938905
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GINA MOORE WILLIAMS M.D.
Provider Business Mailing Address
First Line : 10 CADILLAC DR STE 200
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5078
Country : US
Telephone Number : 901-468-8859
Fax Number : 901-260-8598
Provider Business Practice Location Address
First Line : 10 CADILLAC DR STE 200
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5078
Country : US
Telephone Number : 763-361-1370
Fax Number : 855-217-9933
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 01/27/2023

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