Individual
GARY AUSTIN WISHART
Active
Individual
GARY AUSTIN WISHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000001915
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0181971
BCBS OF TN
TN
01
—
085256
ANTHEM BCBS OF VA
VA
01
—
104229
VALUE OPTIONS
TN
01
—
242191000
MAGELLAN
TN
01
—
4098126
BCBS OF TN MEDICAL
TN
01
—
621618739
AARP
TN
Enumeration date
11/13/2006
Last updated
01/26/2012
Update your record
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