Provider Demographics
NPI:1679521389
Name:WESLEY & KLIPPENSTEIN, PC
Entity Type:Organization
Organization Name:WESLEY & KLIPPENSTEIN, PC
Other - Org Name:WESLEY OPHTHALMIC PLASTIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-329-3624
Mailing Address - Street 1:1800 CHURCH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2233
Mailing Address - Country:US
Mailing Address - Phone:615-329-3624
Mailing Address - Fax:615-329-0639
Practice Address - Street 1:1800 CHURCH ST.
Practice Address - Street 2:SUITE 150
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2233
Practice Address - Country:US
Practice Address - Phone:615-329-3624
Practice Address - Fax:615-329-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000072261QA1903X
261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1000929OtherBCBS PROVIDER ID#
TN3287672Medicare PIN