Wyatt, Susan Dianne

Wyatt, Susan Dianne is an sole proprietor health care provider with primary practice located at 353 New Shackle Island Rd Suite 247C, Hendersonville TN 37075-2379. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wyatt, Susan Dianne can be contacted via phone (615) 824-5064.

Contact Information

Primary practice address
353 New Shackle Island Rd Suite 247C Hendersonville TN 37075-2379
Phone: (615) 824-5064
Fax: (615) 824-0195
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20189 Tennessee

Profile Details

NPI number 1427008416
LBN Legal business name Wyatt, Susan Dianne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2006
Last updated Dec 7th, 2010 - about 16 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 1427008416 NPPES
Tennessee MEDICAID 3048949

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