Wiegand, Clifford Frank

Wiegand, Clifford Frank is an individual health care provider with primary practice located at 107 Woodlawn Dr , Johnson City TN 37604-5978. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Wiegand, Clifford Frank can be contacted via phone (423) 929-7158.

Contact Information

Primary practice address
107 Woodlawn Dr Johnson City TN 37604-5978
Fax: (423) 828-9625
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD18429 Tennessee
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD18429 Tennessee

Profile Details

NPI number 1588669170
LBN Legal business name Wiegand, Clifford Frank
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Dec 28th, 2009 - about 15 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 1588669170 NPPES
Tennessee MEDICAID 3030482

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