Provider Demographics
NPI:1952364762
Name:DAVIDSON, WILLIAM RAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:DAVIDSON
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 1:2201 MURPHY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-0803
Mailing Address - Country:US
Mailing Address - Phone:615-329-3595
Mailing Address - Fax:615-327-4934
Practice Address - Street 1:2201 MURPHY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-0803
Practice Address - Country:US
Practice Address - Phone:615-329-3595
Practice Address - Fax:615-327-4934
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23558208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3068560Medicaid
TN3068560Medicaid