Healthcare Provider Details

I. General information

NPI: 1811802531
Provider Name (Legal Business Name): TAMARA BENTON WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 BOLD SPRINGS RD
MC EWEN TN
37101-4302
US

IV. Provider business mailing address

282 BOLD SPRINGS RD
MC EWEN TN
37101-4302
US

V. Phone/Fax

Practice location:
  • Phone: 931-209-5890
  • Fax:
Mailing address:
  • Phone: 931-209-5890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: