Provider Demographics
NPI:1255661617
Name:TERESA MARIE WILLIAMS, M.D.
Entity Type:Organization
Organization Name:TERESA MARIE WILLIAMS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILLAIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-384-4050
Mailing Address - Street 1:221 NORTHCREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3962
Mailing Address - Country:US
Mailing Address - Phone:615-384-4050
Mailing Address - Fax:615-384-7493
Practice Address - Street 1:221 NORTHCREST DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3962
Practice Address - Country:US
Practice Address - Phone:615-384-4050
Practice Address - Fax:615-384-7493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000039057208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty