Sam J Williams III, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD0000010575 Issued in TN

Practice address

1610 Shore View LN
Hixson, TN 37343-4646

Phone

(404) 842-9740

NPI assigned

Sep 26, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1942551270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22783",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374222783",
            "telephone_number": "404-842-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 SHORE VIEW LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434646",
            "telephone_number": "404-842-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "MD0000010575",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "17749",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ME",
            "license": "MD14405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan E Willard, ED.D.
• William a. Hensley
• William E Matthews MD PC
• Autumn Gene Williams, ATC
• Brittany Craft Williams, NP
• Alvin E Willingham, OD
• Sydney Wingfield, DDS
• Pam Wingo, PTA
• Shannon Maureen Wingo, LCSW
• Lauryn Winslett, OT, MSOT

• Vascular & Interventional Radiology Physician in Hixson, TN
• Providers in Hixson, TN by specialty
• Vascular & Interventional Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.