Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | MD0000040690 | TN |
NPI | 1225180367 |
---|---|
Provider Name | Dr. David Wayne Gentry |
First Address | Powell, TN 37849-4952 |
Second Address | Knoxville, TN 37920-1511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |