Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD0000051036 | TN |
NPI | 1013238054 |
---|---|
Provider Name | Dr. Jason Glenn Williams |
First Address | Memphis, TN 38111-2646 |
Second Address | Memphis, TN 38120-2367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 16/07/2014 |