Individual
DEXTER WITTE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6019 WALNUT GROVE, MEMPHIS, TN 38120
(901) 383-8860
(901) 383-1194
Mailing address
PO BOX 2121, MEMPHIS, TN 38159
(901) 383-8860
(901) 383-8985
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17148
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115955
—
MS
01
—
3017410
BCBS
TN
05
—
3022271
—
TN
01
—
96631
BCBS
AR
Enumeration date
09/07/2006
Last updated
07/08/2007
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