Individual
GORDON MACGREGOR HALL-WURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
320 BRISTOL WEST BLVD STE 1B, BRISTOL, TN 37620-8773
(423) 968-2599
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5750
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2021
Last updated
07/19/2024
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