Healthcare Provider Details
I. General information
NPI: 1548389067
Provider Name (Legal Business Name): BILLY WAYNE AKIN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 21ST AVE S
NASHVILLE TN
37212-4314
US
IV. Provider business mailing address
2000 21ST AVE S
NASHVILLE TN
37212-4314
US
V. Phone/Fax
- Phone: 615-385-3334
- Fax: 615-385-3335
- Phone: 615-385-3334
- Fax: 615-385-3335
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | 6906 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: