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
Phone: (615) 452-7223
Fax: (615) 452-3894
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720183981 | NPPES |
| Tennessee | MEDICAID | 3376661 |
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