Healthcare Provider Details

I. General information

NPI: 1568623973
Provider Name (Legal Business Name): JING WANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PHYSICIANS WAY
FRANKLIN TN
37067-1471
US

IV. Provider business mailing address

PO BOX 847
CORDOVA TN
38088-0847
US

V. Phone/Fax

Practice location:
  • Phone: 315-289-7189
  • Fax:
Mailing address:
  • Phone: 901-821-0338
  • Fax: 901-821-0341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number51803
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: