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General NPI Number Information
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NPI Number | 1316496029
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Entity Type | Organization
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Legal Business Name | WT MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 243 JIM ADAMS DRIVE
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City | PARIS
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State | TN
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Zip | 38242-4967
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Country | US
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Telephone | 731-644-8479
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Fax | 731-644-3719
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Provider Business Mailing Address
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Address Line | 257 BANCORP SOUTH PKWY
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City | JACKSON
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State | TN
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Zip | 38305-7582
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Country | US
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Telephone | 731-660-8759
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BARTLEY TEAGUE
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Credential |
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Telephone | 731-512-1277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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