Provider Demographics
NPI:1356656367
Name:DONALD G. WEGENER,D.C.,P.C.
Entity Type:Organization
Organization Name:DONALD G. WEGENER,D.C.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:WEGENER
Authorized Official - Suffix:
Authorized Official - Credentials:DC,PC
Authorized Official - Phone:865-938-8700
Mailing Address - Street 1:7311 CLINTON HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5224
Mailing Address - Country:US
Mailing Address - Phone:865-938-8700
Mailing Address - Fax:865-938-8706
Practice Address - Street 1:7311 CLINTON HWY
Practice Address - Street 2:SUITE A
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5224
Practice Address - Country:US
Practice Address - Phone:865-938-8700
Practice Address - Fax:865-938-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5159192261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1669538229OtherINDIVIDUAL NPI DONALD G. WEGENER, D.C.,P.C.