Waggoner, Brian S

Waggoner, Brian S is an sole proprietor health care provider with primary practice located at 428 N Willow Ave , Cookeville TN 38501-2339. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Waggoner, Brian S can be contacted via phone (931) 854-9988.

Contact Information

Primary practice address
428 N Willow Ave Cookeville TN 38501-2339
Phone: (931) 854-9988
Fax: (931) 854-9977
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD27530 Tennessee

Profile Details

NPI number 1255331914
LBN Legal business name Waggoner, Brian S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2005
Last updated Jul 14th, 2016 - about 8 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1255331914 NPPES
Tennessee Other 4033875 BLUE CROSS BLUE SHIELD
Tennessee MEDICAID 3812970 BLUE CROSS BLUE SHIELD

Popular Providers