Healthcare Provider Details

I. General information

NPI: 1659341832
Provider Name (Legal Business Name): JOHN P WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 LAUREL AVE SUITE N304
KNOXVILLE TN
37916-1810
US

IV. Provider business mailing address

2001 LAUREL AVE SUITE N304
KNOXVILLE TN
37916-1810
US

V. Phone/Fax

Practice location:
  • Phone: 865-546-9484
  • Fax:
Mailing address:
  • Phone: 865-546-9484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMD28001
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: