National Provider Identifier Database

WYNN HABERSHAM COMMUNITY CLINIC INC
Rural Health


Contact Information

WYNN HABERSHAM COMMUNITY CLINIC INC
1037 STINKING CREEK RD
LAFOLLETTE, TN37766-6108
Phone: 423-784-5110
Fax:
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for WYNN HABERSHAM COMMUNITY CLINIC INC

NPI Number 1417093857
Legal business name
LBN
WYNN HABERSHAM COMMUNITY CLINIC INC
Authorized official CHARLES WILKENS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 01/30/2007
Last updated 07/16/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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