Williams, Travis David

Williams, Travis David is an individual health care provider with primary practice located at 1 Medical Park Blvd Suite 300 E, Bristol TN 37620-7430. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Williams, Travis David can be contacted via phone (423) 844-6450.

Contact Information

Primary practice address
1 Medical Park Blvd Suite 300 E Bristol TN 37620-7430
Phone: (423) 844-6450
Fax: (423) 844-6499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 13596 Tennessee

Profile Details

NPI number 1841446325
LBN Legal business name Williams, Travis David
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2008
Last updated Nov 14th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841446325 NPPES
Tennessee Other 13596 STATE LICENSE NUMBER
Tennessee MEDICAID 33420171 STATE LICENSE NUMBER

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