Mccrary, Theodore W

Mccrary, Theodore W is an individual health care provider with primary practice located at 301 S Gallaher View Rd Ste 224 , Knoxville TN 37919-5361. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mccrary, Theodore W can be contacted via phone (865) 951-2012.

Contact Information

Primary practice address
301 S Gallaher View Rd Ste 224 Knoxville TN 37919-5361
Phone: (865) 951-2012
Fax: (865) 951-2575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 560 Tennessee

Profile Details

NPI number 1356334973
LBN Legal business name Mccrary, Theodore W
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jan 8th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356334973 NPPES
Tennessee MEDICAID 3666869

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