Individual
MR. TRAVIS DAVID WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1 MEDICAL PARK BLVD, SUITE 300 E, BRISTOL, TN 37620-7430
(423) 844-6450
(423) 844-6499
Mailing address
4105 FORT HENRY DR, SUITE 300, KINGSPORT, TN 37663-2240
(423) 239-1550
(423) 239-1544
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13596
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13596
STATE LICENSE NUMBER
TN
05
—
33420171
—
TN
Enumeration date
08/15/2008
Last updated
11/14/2008
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