Provider Demographics
NPI:1508910761
Name:HUGH HERMES WILLIAMS M D
Entity Type:Organization
Organization Name:HUGH HERMES WILLIAMS M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:HERMES
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-276-6277
Mailing Address - Street 1:220 S CLAYBROOK ST
Mailing Address - Street 2:314
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3527
Mailing Address - Country:US
Mailing Address - Phone:901-276-6277
Mailing Address - Fax:901-276-6220
Practice Address - Street 1:220 S CLAYBROOK ST
Practice Address - Street 2:314
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3527
Practice Address - Country:US
Practice Address - Phone:901-276-6277
Practice Address - Fax:901-276-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN012799174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0122060OtherBCBS OF TN
TN3199839Medicaid
TN3199839Medicaid
TNBO4867Medicare UPIN
TN3378650Medicare ID - Type UnspecifiedGROUP NUMBER