Individual
DAVID VILLARREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
395 HOSPITAL BLVD, JACKSON, TN 38305-2080
(731) 664-7395
(731) 664-0057
Mailing address
PO BOX 11955, JACKSON, TN 38308-0132
(731) 664-7395
(731) 664-0057
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26380
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020033489
RAILROAD MEDICARE
TN
01
—
3060477
BLUE CROSS OF TN
TN
05
—
3089277
—
TN
01
—
5969342
AETNA
TN
Enumeration date
06/15/2005
Last updated
01/08/2013
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