Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | TN07689 | TN |
N | 207R00000X | Internist | TN07689 | TN |
N | 111NI0900X | Internist | TN07689 | TN |
NPI | 1194830612 |
---|---|
Provider Name | William Bennett Ralph JR. |
First Address | Nashville, TN 37203-1844 |
Second Address | Nashville, TN 37203-1844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3156175 | (05) | TN |
D70150 | (02) |