Bacon, Stuart P

Bacon, Stuart P is an sole proprietor health care provider with primary practice located at 7794 Rhea County Hwy Suite 101, Dayton TN 37321-5981. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bacon, Stuart P can be contacted via phone (423) 775-4261.

Contact Information

Primary practice address
7794 Rhea County Hwy Suite 101 Dayton TN 37321-5981
Phone: (423) 775-4261
Fax: (423) 570-2008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD9006 Tennessee

Profile Details

NPI number 1003816794
LBN Legal business name Bacon, Stuart P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2005
Last updated Jul 8th, 2007 - 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 1003816794 NPPES
Tennessee MEDICAID 3164361

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