Provider Demographics
NPI:1881626778
Name:WEATHERSBY, JOSEPH SETH (PA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:SETH
Last Name:WEATHERSBY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:ONE VANTAGE WAY
Mailing Address - Street 2:SUITE B240 MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1562
Mailing Address - Country:US
Mailing Address - Phone:615-329-4020
Mailing Address - Fax:615-329-9479
Practice Address - Street 1:400 N. HIGHLAND AVE.
Practice Address - Street 2:MIDDLE TENNESSEE MEDICAL CENTER
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:800-251-2014
Practice Address - Fax:615-284-3854
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-06-13
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Provider Licenses
StateLicense IDTaxonomies
TN1013363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3689512Medicare ID - Type Unspecified
TNP86386Medicare UPIN