Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 82716 | TN |
NPI | 1063642403 |
---|---|
Provider Name | John William Beddies |
First Address | Paris, TN 38242-9561 |
Second Address | Paris, TN 38242-5846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2009 |
Last Update Date | 21/04/2016 |