Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | DR.0031561 | CO |
N | 208000000X | Pediatrician | MD25323 | TN |
N | 2080P0204X | Pediatric Emergency Doctor | MD25323 | TN |
NPI | 1194752915 |
---|---|
Provider Name | Dr. John R. Williams |
First Address | Greenwood Village, CO 80111-4727 |
Second Address | Knoxville, TN 37916-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 23/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3030975 | BLUE CROSS (01) | TN |
3897786 | (05) | TN |
64920598 | (05) | KY |
F63955 | (02) | TN |