Provider Demographics
NPI:1972663144
Name:WILLIAMS, RICHARD IRWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IRWIN
Last Name:WILLIAMS
Suffix:
Gender:M
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:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-243-8153
Mailing Address - Fax:
Practice Address - Street 1:315 N WASHINGTON AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2603
Practice Address - Country:US
Practice Address - Phone:800-264-3762
Practice Address - Fax:615-292-9469
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN274262081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ012854Medicaid
TNG16395Medicare UPIN
3095640Medicare ID - Type Unspecified