Provider Demographics
NPI:1437229572
Name:WILLIAMS, TRILBY ELLISTON (MD)
Entity Type:Individual
Prefix:
First Name:TRILBY
Middle Name:ELLISTON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 PATTERSON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2134
Mailing Address - Country:US
Mailing Address - Phone:615-329-0885
Mailing Address - Fax:615-329-0824
Practice Address - Street 1:330 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1844
Practice Address - Country:US
Practice Address - Phone:615-329-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000029855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3373619Medicaid
TN38177431Medicaid
TN1512269Medicaid
TN3373619Medicaid
G60123Medicare UPIN
TN3373619Medicare ID - Type Unspecified
TN1512269Medicaid
TN38177431Medicaid
TN38177431Medicare PIN