Healthcare Provider Details

I. General information

NPI: 1457685331
Provider Name (Legal Business Name): STEVEN WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2009
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6005 PARK AVE STE 624B
MEMPHIS TN
38119
US

IV. Provider business mailing address

6005 PARK AVE STE 624B
MEMPHIS TN
38119-0214
US

V. Phone/Fax

Practice location:
  • Phone: 901-682-1100
  • Fax: 19-682-6915
Mailing address:
  • Phone: 901-682-1100
  • Fax: 19-682-6915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number241508
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME124723
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberRS2013-0106
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME124723
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number56690
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: