Individual
DR. FRED G. WENGER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1924 ALCOA HWY, KNOXVILLE, TN 37920-1511
(865) 544-9000
(865) 539-8008
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1526
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3897961
—
TN
01
—
4083217
BLUE CROSS
TN
05
—
64084650
—
KY
01
—
P00290276
RAILROAD MEDICARE
TN
Enumeration date
07/05/2006
Last updated
11/15/2007
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