Healthcare Provider Details

I. General information

NPI: 1417920240
Provider Name (Legal Business Name): DONALD GREGORY WHEATLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 20TH ST SUITE 505
KNOXVILLE TN
37916-1809
US

IV. Provider business mailing address

501 20TH ST SUITE 505
KNOXVILLE TN
37916-1809
US

V. Phone/Fax

Practice location:
  • Phone: 865-546-0157
  • Fax: 865-546-6144
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberTN024544
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: