Provider Demographics
NPI:1649292160
Name:BREWER, WILLIAM WESLEY (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WESLEY
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1224 TROTWOOD AVENUE
Mailing Address - Street 2:SOUTHERN RADIOLOGY ASSOCIATES, PLLC
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-8402
Mailing Address - Country:US
Mailing Address - Phone:931-388-1286
Mailing Address - Fax:931-388-7119
Practice Address - Street 1:1224 TROTWOOD AVENUE
Practice Address - Street 2:SOUTHERN RADIOLOGY ASSOCIATES, PLLC
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-8402
Practice Address - Country:US
Practice Address - Phone:931-388-1286
Practice Address - Fax:931-388-7119
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD403612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3386891Medicaid
TN3336951Medicare PIN