Individual
DR. WALTER JOHN JERMAKOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
105 S WILLOW AVE, COOKEVILLE, TN 38501-4667
(931) 372-7716
(931) 372-7717
Mailing address
105 S WILLOW AVE, COOKEVILLE, TN 38501-4667
(931) 372-7716
(931) 372-7717
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
58744
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58744
TENNESSEE MEDICAL LICENSE
TN
05
—
Q054619
—
TN
Enumeration date
06/07/2012
Last updated
04/12/2022
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