Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 9332 | TN |
NPI | 1073773594 |
---|---|
Provider Name | Dr. Carl Andrew Williamson |
First Address | Spring Hill, TN 37174-6122 |
Second Address | Spring Hill, TN 37174 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 28/08/2012 |