Individual
DR. STUART P BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7794 RHEA COUNTY HWY, SUITE 101, DAYTON, TN 37321-5981
(423) 775-4261
(423) 570-2008
Mailing address
7794 RHEA COUNTY HWY, SUITE 101, DAYTON, TN 37321-5981
(423) 775-4261
(423) 570-2008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD9006
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3164361
—
TN
Enumeration date
07/26/2005
Last updated
07/08/2007
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