Oberdick, Wendy Tipton
Oberdick, Wendy Tipton is an sole proprietor health care provider with primary practice located at 105 W Stone Dr Ste 1F, Kingsport TN 37660-3365. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Oberdick, Wendy Tipton can be contacted via phone (423) 230-2420.Contact Information
Primary practice address
105 W Stone Dr Ste 1F
Kingsport TN 37660-3365
Phone: (423) 230-2420
Fax: (423) 230-2422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 200133 | Louisiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD200133 | Louisiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD46567 | Tennessee |
Profile Details
| NPI number | 1659374601 |
|---|---|
| LBN Legal business name | Oberdick, Wendy Tipton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2005 |
| Last updated | Oct 20th, 2011 - about 14 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 | 1659374601 | NPPES |
| Louisiana | MEDICAID | 1623512 | |
| Louisiana | MEDICAID | 1520114 |
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