Organization
WAVERLY PEDIATRIC AND ADULT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ANGELA SKELTON M.D. (OWNER)
(931) 296-7000
Entity
Organization
Contact information
Practice address
1034 W MAIN ST, WAVERLY, TN 37185-1447
(931) 296-7000
(931) 296-7231
Mailing address
1034 W MAIN ST, WAVERLY, TN 37185-1447
(931) 296-7000
(931) 296-7231
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD8719
TN
364SF0001X
Family Health Clinical Nurse Specialist
APN0000015777
TN
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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