Bacon, John Wayne

Bacon, John Wayne is an sole proprietor health care provider with primary practice located at 300 Steam Plant Rd Suite 210, Gallatin TN 37066-3032. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bacon, John Wayne can be contacted via phone (615) 452-7223.

Contact Information

Primary practice address
300 Steam Plant Rd Suite 210 Gallatin TN 37066-3032
Fax: (615) 452-3894
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD0000035633 Tennessee

Profile Details

NPI number 1720183981
LBN Legal business name Bacon, John Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2006
Last updated Apr 18th, 2008 - about 17 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 1720183981 NPPES
Tennessee MEDICAID 3376661

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