Organization
WEST TENNESSEE ENT CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM KEITH WAINSCOTT M.D. (PRESIDENT)
(731) 424-3682
Entity
Organization
Contact information
Practice address
619 SKYLINE DR, JACKSON, TN 38301-3903
(731) 424-3682
(731) 423-2714
Mailing address
619 SKYLINE DR, JACKSON, TN 38301-3903
(731) 424-3682
(731) 423-2714
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3382042
—
TN
Enumeration date
08/17/2005
Last updated
08/22/2020
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