Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TH0100X | Health Service | P787 | TN |
NPI | 1306854559 |
---|---|
Provider Name | Dr. Billy W Flatt |
First Address | Cookeville, TN 38501 |
Second Address | Cookeville, TN 38501-7119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 02/04/2008 |