Doctor Name: | DUDLEY WHITCOMB |
NPI Number: | 1346527900 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 66291 |
Business Practice Address: | 109 W Watauga Ave Johnson City, TN - 376045621 |
Business Phone Number: | 4232322600 |
Business Fax Number: | 4234673644 |
Mailing Address: | 1167 Spratlin Park Dr, GRAY |
State: | TN |
Postal Code: | 376156205 |
Phone Number: | 4234673600 |
Fax Number: | 4234673644 |
NPI Enumeration Date: | 11/10/2011 |
NPI Last Update Date: | 11/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 66291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |