Provider Demographics
NPI:1174667224
Name:WILLIAMS, WILLARD DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:DAVID
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 BUSHNELL ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-1821
Mailing Address - Country:US
Mailing Address - Phone:615-650-0531
Mailing Address - Fax:
Practice Address - Street 1:25 WHITE BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1402
Practice Address - Country:US
Practice Address - Phone:615-353-0300
Practice Address - Fax:
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
TNODT-1302152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist