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General NPI Number Information
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NPI Number | 1700889888
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Entity Type | Individual
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Provider Name | WILLIAM WALTER WASSYNGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 228 W 4TH ST STE 200
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City | COOKEVILLE
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State | TN
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Zip | 38501-2489
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Country | US
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Telephone | 931-372-0405
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Fax | 931-372-0463
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Provider Business Mailing Address
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Address Line | 228 W 4TH ST STE 200
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City | COOKEVILLE
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State | TN
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Zip | 38501-2489
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Country | US
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Telephone | 931-783-5582
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Fax | 931-526-6760
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | TP580
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | TP580
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 37302
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License Number State | TN
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