Dr Justin Wade Widner, DO is a
Pediatrics physician based in Tazewell, Tennessee. Dr Justin Wade Widner is licensed to practice in Tennessee (license number 3903) and his current practice location is 1610 Tazewell Rd Ste 203, Tazewell, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(423) 259-3701.
NPI number for Dr Justin Wade Widner is 1225566953 and his current mailing address is Po Box 15004, Knoxville, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1225566953.
Physician's Profile
| Full Name | Dr Justin Wade Widner |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 1610 Tazewell Rd Ste 203, Tazewell, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1225566953
- Provider Enumeration Date: 05/25/2017
- Last Update Date: 04/08/2022
Medical Identifiers
Medical identifiers for Dr Justin Wade Widner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225566953 | NPI | - | NPPES |
| Q042576 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 3903 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Justin Wade Widner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Justin Wade Widner, DO
Po Box 15004,
Knoxville, TN 37901-5004
Ph: (865) 541-8895 | Dr Justin Wade Widner, DO
1610 Tazewell Rd Ste 203,
Tazewell, TN 37879-3648
Ph: (423) 259-3701 |
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