Individual
DARTHVADER DEVON WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA
Contact information
Practice address
2986 KATE BOND RD, BARTLETT, TN 38133-4003
(901) 820-7468
Mailing address
13560 HIGHWAY 196, EADS, TN 38028-3606
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
MAS0000000047
TN
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
04/14/2019
Last updated
04/14/2019
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