Individual
EDIE WADSWORTH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
420 W MORRIS BLVD, HEALTHSTAR PHYSICIANS STE 400G, MORRISTOWN, TN 37813-2283
(423) 586-2410
(423) 581-9692
Mailing address
420 W MORRIS BLVD, HEALTHSTAR PHYSICIANS STE 400G, MORRISTOWN, TN 39813
(423) 586-2410
(423) 581-9692
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD34074
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3861633
—
TN
Enumeration date
05/11/2006
Last updated
07/08/2007
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