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Individual

DR. WILLIAM ANDREW MALEC

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
201 E LAFAYETTE ST, JACKSON, TN 38301-6250
(731) 422-3811
(731) 422-5681
Mailing address
201 E LAFAYETTE ST, JACKSON, TN 38301-6217
(731) 422-3811
(731) 422-5681

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1173
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3598725
TN
Enumeration date
10/19/2005
Last updated
09/11/2019
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