Provider Demographics
NPI:1134233729
Name:FLOWERS, WILLIAM P JR (CRNA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:P
Last Name:FLOWERS
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:901-226-3186
Mailing Address - Fax:901-578-2572
Practice Address - Street 1:80 HUMPHREYS CENTER DR STE 210
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2353
Practice Address - Country:US
Practice Address - Phone:901-761-3900
Practice Address - Fax:901-578-2572
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNRN 63803163W00000X
GA168219367500000X
TNAPN 9282367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR168025001Medicaid
TN36206501Medicaid
GA000774419EMedicaid
TN4216772OtherBLUE CROSS
TNP00609674OtherRAILROAD MEDICARE
MS07378790Medicaid
MS07378790Medicaid