=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285840975
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICIA W. WILLIAMS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 329 KEATHLEY UNIVERSITY CTR
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37132-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-898-2670
-----------------------------------------------------
Fax | 615-904-8284
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2016 KEENLAND DR
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37127-6685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-896-3263
-----------------------------------------------------
Fax | 615-904-8284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD022066
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------