Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 2015040981 | MO |
N | 213ES0103X | Foot & Ankle Surgery | 252471 | KY |
Y | 213ES0103X | Foot & Ankle Surgery | DPM0000000884 | TN |
NPI | 1093085367 |
---|---|
Provider Name | Ann Wolford |
First Address | Kingsport, TN 37660-7398 |
Second Address | Kingsport, TN 37660-7398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2012 |
Last Update Date | 29/07/2021 |