Individual
JILL WALLNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
58 W FIRST ST, SUITE 101, CROSSVILLE, TN 38555-4443
(931) 456-7992
(931) 707-1089
Mailing address
58 W FIRST ST, CROSSVILLE, TN 38555-4443
(931) 456-7992
(931) 707-1089
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
MD 27432
TN
207QA0505X
Adult Medicine Physician
Primary
MD 27432
TN
Other
Enumeration date
01/04/2007
Last updated
07/23/2010
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