Healthcare Provider Details

I. General information

NPI: 1548026222
Provider Name (Legal Business Name): WILLIAM ELI ESLICK III RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 COLD SPRINGS RD
FAYETTEVILLE TN
37334-6551
US

IV. Provider business mailing address

57 COLD SPRINGS RD
FAYETTEVILLE TN
37334-6551
US

V. Phone/Fax

Practice location:
  • Phone: 931-625-3778
  • Fax:
Mailing address:
  • Phone: 931-625-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRRT3270
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: