Individual
DR. BRIAN SCOTT WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 929-2584
(423) 722-2060
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 929-2584
(423) 722-2060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
51565
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51565
MEDICAL LICENSE
TN
Enumeration date
06/01/2011
Last updated
08/01/2014
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