Healthcare Provider Details

I. General information

NPI: 1609053404
Provider Name (Legal Business Name): WILLIAMS FOOT CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 DOOLITTLE RD
WOODBURY TN
37190-1139
US

IV. Provider business mailing address

1725 MEDICAL CENTER PKWY STE 110
MURFREESBORO TN
37129-2594
US

V. Phone/Fax

Practice location:
  • Phone: 615-494-1234
  • Fax: 615-494-1236
Mailing address:
  • Phone: 615-494-1234
  • Fax: 615-494-1236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM469
License Number StateTN

VIII. Authorized Official

Name: JANE WILLIAMS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 614-494-1234