IndividualActive
Darthvader Williamson, RSA
NPI 1972166114 · Surgical Assistant · Bartlett, TN
Provider details
- NPI number
- 1972166114
- Entity type
- Individual
- Primary specialty
- Surgical AssistantTechnologists, Technicians & Other Technical Service Providers
- Credential
- RSA
- Sex
- Male
- Sole proprietor
- Yes
- License
- MAS0000000047 (TN)
Mailing address
13560 Highway 196
Eads, TN 38028-3606
Registry dates
- Enumerated
- 2019-04-14
- Last updated
- 2019-04-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.