Organization
WILLIAMS PRIMARY CARE OF TRI-CITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY WILLIAMS-CORDEIRO NP (OWNER)
(423) 384-2820
Entity
Organization
Contact information
Practice address
1901 BROOKSIDE DR STE 105, KINGSPORT, TN 37660-4617
(423) 384-2820
Mailing address
1901 BROOKSIDE DR STE 105, KINGSPORT, TN 37660-4617
(423) 384-2820
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
BC18066
TN
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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