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Organization

WT MEDICAL ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BARTLEY TEAGUE (EXECUTIVE DIRECTOR)
(731) 512-1277
Entity
Organization

Contact information

Practice address
1629 WOODLAWN AVE, DYERSBURG, TN 38024
(731) 512-1277
(731) 285-1440
Mailing address
257 BANCORP SOUTH PKWY, JACKSON, TN 38305-7582

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
363L00000X
Nurse Practitioner
363LA2100X
Acute Care Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner
363LW0102X
Women's Health Nurse Practitioner
367A00000X
Advanced Practice Midwife

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q037006
TN
Enumeration date
04/25/2018
Last updated
10/30/2025
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