Healthcare Provider Details

I. General information

NPI: 1083018048
Provider Name (Legal Business Name): WILLIAM J. WILLIAMS, DO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 W MORRIS BLVD SUITE 300A
MORRISTOWN TN
37813-3860
US

IV. Provider business mailing address

1907 W MORRIS BLVD SUITE 300A
MORRISTOWN TN
37813-3860
US

V. Phone/Fax

Practice location:
  • Phone: 423-353-1152
  • Fax: 423-353-1157
Mailing address:
  • Phone: 423-353-1152
  • Fax: 423-353-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number962
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number962
License Number StateTN

VIII. Authorized Official

Name: DR. WILLIAM J. WILLIAMS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 423-353-1152