Individual
DR. TAVARES KINTE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Mailing address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
46412
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519998
—
TN
01
—
3380640
MEDICAID GROUP
TN
Enumeration date
08/22/2008
Last updated
12/01/2011
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