Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD0000045099 | TN |
NPI | 1093930216 |
---|---|
Provider Name | Dr. Jody Benton Helms |
First Address | Bristol, TN 37620-7431 |
Second Address | Bristol, TN 37620-7431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2007 |
Last Update Date | 18/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093930216 | (05) | VA |
1518499 | (05) | TN |