Darthvader Devon Williamson, RSA
Specialist/Technologist, Other, Surgical Assistant in Bartlett, TN. Individual provider (NPI-1).
NPI number1972166114
StatusActive
Last updated in NPPESApr 14, 2019
Details
- NPI
- 1972166114
- Entity type
- Individual (NPI-1)
- Name
- Darthvader Devon Williamson
- Credential
- RSA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 14, 2019
- Last updated
- Apr 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | – | – | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | MAS0000000047 | TN |
Practice location
2986 Kate Bond RdBartlett, TN 38133-4003
Phone 901-820-7468
Mailing address
13560 Highway 196Eads, TN 38028-3606
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