Organization
MANCEL WAKHAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANCEL WAKHEM MD (OWNER)
(865) 621-3601
Entity
Organization
Contact information
Practice address
1000 BRADFORD WAY STE 500, KINGSTON, TN 37763-3126
(865) 621-3601
(865) 409-5733
Mailing address
1000 BRADFORD WAY STE 500, KINGSTON, TN 37763-3126
(865) 621-3601
(865) 409-5733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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