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General NPI Number Information
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NPI Number | 1700256971
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Entity Type | Organization
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Legal Business Name | KENNETH L WILLIAMS MD PHD
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 525 ROYAL PKWY
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City | NASHVILLE
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State | TN
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Zip | 37229-2878
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Country | US
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Telephone | 615-579-2772
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 292878
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City | NASHVILLE
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State | TN
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Zip | 37229-2878
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Country | US
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Telephone | 615-579-2772
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / CHIEF MEDICAL OFFICER
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Name | DR. KENNETH LAMONT WILLIAMS
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Credential | M.D., PH.D.
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Telephone | 615-579-2772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 46286
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License Number State | TN
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