Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD0000010621 | TN |
N | 207YP0228X | Pediatric Otolaryngology | MD0000010621 | TN |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD0000010621 | TN |
NPI | 1528006707 |
---|---|
Provider Name | Dr. Richard W Quisling |
First Address | Hermitage, TN 37076-2054 |
Second Address | Hermitage, TN 37076-2054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 08/07/2007 |