Basic Information
Provider Information
NPI: 1831483502
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: KARA
MiddleName: MARI
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1275 DICK LONAS RD UNIT 101
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379091383
CountryCode: US
TelephoneNumber: 8655844747
FaxNumber: 8655841363
Practice Location
Address1: 6537 KINGSTON PIKE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379194826
CountryCode: US
TelephoneNumber: 8655844747
FaxNumber: 8655841363
Other Information
ProviderEnumerationDate: 05/31/2011
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X1979TNY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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