Provider Demographics
NPI:1164566451
Name:WILLIAMS, PATRICK WAYNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WAYNE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BLUEGRASS PKWY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-8947
Mailing Address - Country:US
Mailing Address - Phone:615-449-4714
Mailing Address - Fax:615-220-5115
Practice Address - Street 1:608 ENON SPRINGS RD E
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4410
Practice Address - Country:US
Practice Address - Phone:615-220-5432
Practice Address - Fax:615-220-5115
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9781183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist