Provider Demographics
NPI:1437184801
Name:WILLIAMS, DARRELL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:JAMES
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 WALLACE ROAD
Mailing Address - Street 2:C310
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-834-8310
Mailing Address - Fax:615-834-5242
Practice Address - Street 1:397 WALLACE ROAD
Practice Address - Street 2:C310
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-834-8310
Practice Address - Fax:615-834-5242
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD021697207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3702958Medicaid
TN3702958Medicaid
F09637Medicare UPIN