Provider Demographics
NPI:1477647220
Name:THAYER, WESLEY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:PAUL
Last Name:THAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-3759
Mailing Address - Fax:615-936-0167
Practice Address - Street 1:D-4207 MEDICAL CENTER NORTH
Practice Address - Street 2:VANDERBILT MEDICAL CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2345
Practice Address - Country:US
Practice Address - Phone:615-936-3759
Practice Address - Fax:615-936-0167
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39708208200000X, 208600000X, 2086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand