Dishmon, Dwight Anthony
Dishmon, Dwight Anthony is an individual health care provider with primary practice located at 1251 Wesley Dr Suite 153, Memphis TN 38116-6442. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Dishmon, Dwight Anthony can be contacted via phone (901) 763-0200.Contact Information
Primary practice address
1251 Wesley Dr Suite 153
Memphis TN 38116-6442
Phone: (901) 763-0200
Fax: (901) 761-4002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 39198 | Tennessee |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 39198 | Tennessee |
Profile Details
| NPI number | 1316904048 |
|---|---|
| LBN Legal business name | Dishmon, Dwight Anthony |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 27th, 2006 |
| Last updated | Aug 26th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316904048 | NPPES |
| Tennessee | MEDICAID | 3325860 | |
| Tennessee | MEDICAID | 155106001 | |
| Tennessee | Other | 4354768 | |
| Tennessee | Other | P01301155 | |
| Tennessee | MEDICAID | 07222339 |
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