Provider Demographics
NPI:1265869853
Name:MYERS, WILLIE JAMES JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIE
Middle Name:JAMES
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3903 BRUSH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-1903
Mailing Address - Country:US
Mailing Address - Phone:615-730-9450
Mailing Address - Fax:615-730-9450
Practice Address - Street 1:2720 CLARKSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-1259
Practice Address - Country:US
Practice Address - Phone:615-730-9450
Practice Address - Fax:615-730-9450
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN19229207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine