Healthcare Provider Details

I. General information

NPI: 1912999129
Provider Name (Legal Business Name): WILLIAM MARSHALL PLATT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK BLVD STE 400E
BRISTOL TN
37620-7431
US

IV. Provider business mailing address

1 MEDICAL PARK BLVD STE 400E
BRISTOL TN
37620-7431
US

V. Phone/Fax

Practice location:
  • Phone: 423-844-5400
  • Fax: 423-844-5434
Mailing address:
  • Phone: 423-844-5400
  • Fax: 423-844-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number20696
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number20696
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: