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General NPI Number Information
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NPI Number | 1184281974
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Entity Type | Individual
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Provider Name | ANTHONY DEVONTE WILBERT MD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 1310 24TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-2637
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Country | US
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Telephone | 615-873-8459
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WATTS CIR APT 417
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City | NASHVILLE
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State | TN
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Zip | 37209-4410
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Country | US
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Telephone | 662-394-2730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 67692
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License Number State | TN
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