Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD025468 | TN |
NPI | 1447312509 |
---|---|
Provider Name | Mr. Barry William Donesky |
First Address | Chattanooga, TN 37424-0867 |
Second Address | Chattanooga, TN 37421-3157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 21/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141932371 | TAX IDENTIFICATION (01) | TN |
3083889 | (05) | TN |
4111335 | BLUE CROSS OF TENNESSEE (01) | TN |
74-40066 | UNITED HEALTHCARE (01) | TN |
E95423 | (02) | TN |