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Individual

WILLIAM JEFFERSON TERRY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604
(423) 431-6111
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
01093639A
IN
208800000X
Urology Physician
Primary
AL30001
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149810
AL
01
511-36669
BLUE CROSS BLUE SHEILD OF ALABAMA
AL
Enumeration date
06/19/2008
Last updated
06/13/2024
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