Provider Demographics
NPI:1467639815
Name:ROBIN WILLIAMS, MD, PLC
Entity Type:Organization
Organization Name:ROBIN WILLIAMS, MD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-316-9511
Mailing Address - Street 1:5651 FRIST BLVD
Mailing Address - Street 2:SUITE 717
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2060
Mailing Address - Country:US
Mailing Address - Phone:615-316-9511
Mailing Address - Fax:
Practice Address - Street 1:5651 FRIST BLVD
Practice Address - Street 2:SUITE 717
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2060
Practice Address - Country:US
Practice Address - Phone:615-316-9511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD25969208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3086467Medicaid
TN3715837OtherMEDICARE GROUP #
TN3086467Medicaid