Provider Demographics
NPI:1912918491
Name:WILLIAMS, JAMES L II (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:WILLIAMS
Suffix:II
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 1:500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382
Mailing Address - Country:US
Mailing Address - Phone:731-855-3510
Mailing Address - Fax:731-855-1387
Practice Address - Street 1:500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382
Practice Address - Country:US
Practice Address - Phone:731-855-3510
Practice Address - Fax:731-855-1387
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18335207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3037718Medicaid
D71860Medicare UPIN
TN3037718Medicaid