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General NPI Number Information
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NPI Number | 1992781751
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Entity Type | Individual
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Provider Name | MICHAEL TYELAR WILLIAMS M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 404 S WHITE ST
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City | ATHENS
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State | TN
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Zip | 37303-4732
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Country | US
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Telephone | 423-745-4322
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Fax |
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Provider Business Mailing Address
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Address Line | 2522 HIGHWAY 39 E
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City | ENGLEWOOD
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State | TN
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Zip | 37329-5362
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD37798
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License Number State | TN
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