1679521389 NPI number — WESLEY & KLIPPENSTEIN, PC

Table of content: (NPI 1679521389)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679521389 NPI number — WESLEY & KLIPPENSTEIN, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESLEY & KLIPPENSTEIN, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679521389
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 CHURCH ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-2233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-329-3624
Provider Business Mailing Address Fax Number:
615-329-0639

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 CHURCH ST.
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-329-3624
Provider Business Practice Location Address Fax Number:
615-329-0639
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WESLEY
Authorized Official First Name:
RALPH
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-329-3624

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA1903X , with the licence number: 0000000072 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1000929 . This is a "BCBS PROVIDER ID#" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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