Individual
MAYNARD W AUSTIN
Active
Individual
MAYNARD W AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
06304
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110190591
RR MEDICARE
TN
05
—
3145919
—
TN
Enumeration date
06/21/2006
Last updated
01/05/2010
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