Provider Demographics
NPI:1891942264
Name:DIZOL, WILLIAM WAYMAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WAYMAN
Last Name:DIZOL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 MCKEAN DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6903
Mailing Address - Country:US
Mailing Address - Phone:615-625-3022
Mailing Address - Fax:615-625-3022
Practice Address - Street 1:5202 MURFREESBORO RD
Practice Address - Street 2:
Practice Address - City:LA VERGNE
Practice Address - State:TN
Practice Address - Zip Code:37086-2714
Practice Address - Country:US
Practice Address - Phone:615-793-3784
Practice Address - Fax:615-213-2544
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist