Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 22149 | TN |
NPI | 1023097177 |
---|---|
Provider Name | Dr. Allen Stephen Uhlik |
First Address | Copperhill, TN 37317-1080 |
Second Address | Copperhill, TN 37317-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2006 |
Last Update Date | 17/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000486692A | (05) | GA |
3065590 | (05) | TN |
41452 | BLUECROSS TENNESSEE (01) | TN |
890563Z | (05) | NC |
D67410 | (02) | TN |