1922089903 NPI number — DR. GARY DOUGLAS CORRIE MD

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	CORRIE
Provider First Name	:	GARY
Provider Middle Name	:	DOUGLAS
Provider Name Prefix Text	:	DR.
Provider Name Suffix Text	:
Provider Credential Text	:	MD
Provider Gender Code	:	M

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Provider Other First Name	:
Provider Other Middle Name	:
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NPI Number	:	1922089903
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	01/21/2010
NPI Deactivation Reason Code	:
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Provider First Line Business Mailing Address	:	155 HOSPITAL RD
Provider Second Line Business Mailing Address	:	STE C
Provider Business Mailing Address City Name	:	WINCHESTER
Provider Business Mailing Address State Name	:	TN
Provider Business Mailing Address Postal Code	:	373982494
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	9319671119
Provider Business Mailing Address Fax Number	:

Provider First Line Business Practice Location Address	:	155 HOSPITAL RD
Provider Second Line Business Practice Location Address	:	STE C
Provider Business Practice Location Address City Name	:	WINCHESTER
Provider Business Practice Location Address State Name	:	TN
Provider Business Practice Location Address Postal Code	:	373982494
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	9319671119
Provider Business Practice Location Address Fax Number	:
Provider Enumeration Date	:	11/08/2005

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• Taxonomy code: 208800000X , with the licence number:  37542 , registered in the state of TN .

• Identifier: E80517 , issued by the state of ( TN ) . This identifiers is of the category "".