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NPI Code Detail

MEDICARE: SCOTTLYN WILLIAMS PA

MEDICARE:   SCOTTLYN  WILLIAMS  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1356200869
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTTLYN WILLIAMS PA
Provider Business Mailing Address
First Line : 877 JEFFERSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2807
Country : US
Telephone Number : 901-545-7100
Fax Number :
Provider Business Practice Location Address
First Line : 877 JEFFERSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2807
Country : US
Telephone Number : 901-545-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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Directions to “ SCOTTLYN WILLIAMS PA” Practice Location

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