Healthcare Provider Details

I. General information

NPI: 1669538229
Provider Name (Legal Business Name): DONALD GILBERT WEGENER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DONALD GILBERT WEGENER D.C.

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7311 CLINTON HWY SUITE A
POWELL TN
37849-5224
US

IV. Provider business mailing address

7311 CLINTON HWY SUITE A
POWELL TN
37849-5224
US

V. Phone/Fax

Practice location:
  • Phone: 865-938-8700
  • Fax: 865-938-8706
Mailing address:
  • Phone: 865-938-8700
  • Fax: 865-938-8706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC 382
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: