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Individual

WAYNE D. FOGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11416 GRIGSBY CHAPEL RD, SUITE 104, KNOXVILLE, TN 37934-1679
(865) 671-2595
Mailing address
11416 GRIGSBY CHAPEL RD, SUITE 104, KNOXVILLE, TN 37934-1679
(865) 671-2595

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14041
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3018611
TN
Enumeration date
08/25/2006
Last updated
07/08/2007
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