Individual
JEFFREY WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1068 CRESTHAVEN RD, SUITE 150, MEMPHIS, TN 38119-0800
(901) 682-6828
Mailing address
PO BOX 171181, MEMPHIS, TN 38187-1181
(901) 682-2872
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD36675
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01971304
MS MEDICAID
MS
01
—
175395001
ARKANSAS MEDICAID
AR
05
—
3877686
—
TN
01
—
4050020
BLUE CROSS
TN
01
—
P00110752
RAILROAD
—
Enumeration date
07/13/2006
Last updated
10/26/2016
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