Organization
MARK A WILLIAMS M D PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A WILLIAMS M. D. (PRESIDENT)
(901) 287-4030
Entity
Organization
Contact information
Practice address
770 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 287-4030
(901) 287-4094
Mailing address
770 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 287-4030
(901) 287-4094
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
MD000000184448
TN
2088P0231X
Pediatric Urology Physician
Primary
MD000000184448
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128654
—
TN
01
—
1599052009
CIGNA
TN
01
—
4038478
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/11/2008
Last updated
06/11/2008
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