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Individual

WILLIAM WALTER WASSYNGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
228 W 4TH ST STE 200, COOKEVILLE, TN 38501-2489
(931) 372-0405
(931) 372-0463
Mailing address
228 W 4TH ST STE 200, COOKEVILLE, TN 38501-2489
(931) 783-5582
(931) 526-6760

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
TP580
KY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
37302
TN
207RC0001X
Clinical Cardiac Electrophysiology Physician
TP580
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1510044
TN
05
3881608
TN
01
6011815
BLUE CROSS-BLUE SHIELD
TN
01
P00669730
RR MEDICARE
TN
Enumeration date
05/23/2005
Last updated
06/17/2022
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