Organization
PMA SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TURNEY WILLIAMS MD (MEDICAL DIRECTOR)
(423) 232-6120
Entity
Organization
Contact information
Practice address
101 MED TECH PKWY, SUITE 205, JOHNSON CITY, TN 37604-4007
(423) 232-9420
(423) 232-9425
Mailing address
101 MED TECH PKWY, SUITE 205, JOHNSON CITY, TN 37604-4007
(423) 232-9420
(423) 232-9425
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007949702
AETNA
TN
01
—
100048318
PHP TENNCARE
TN
05
—
3288982
—
TN
01
—
4097786
BLUE CROSS BLUE SHIELD
—
01
—
604059200
US DEPT OF LABOR
—
01
—
702040581
CARITEN
—
01
—
P00188946
MEDICARE RAILROAD
—
01
—
TN010
UNITED HEALTHCARE OF THE NEW RIVER VALLEY
—
Enumeration date
07/02/2008
Last updated
07/02/2008
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