Dr Paul Douglas Wentland, MD | |
1508 Tombras Ave, East Ridge, TN 37412-2720 | |
(423) 867-4969 | |
(423) 867-4971 |
Full Name | Dr Paul Douglas Wentland |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 1508 Tombras Ave, East Ridge, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841478625 | NPI | - | NPPES |
Q018129 | Medicaid | TN | |
5462860 | Other | TN | BCBS OF TENNESSEE |
003171303A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 40539 (Tennessee) | Primary |
207R00000X | Internal Medicine | 74929 (Georgia) | Secondary |
Entity Name | Your Good Health, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386864296 PECOS PAC ID: 3173615838 Enrollment ID: O20080806000348 |
Mailing Address | Practice Location Address |
---|---|
Dr Paul Douglas Wentland, MD 1508 Tombras Ave, East Ridge, TN 37412-2720 Ph: (423) 867-4969 | Dr Paul Douglas Wentland, MD 1508 Tombras Ave, East Ridge, TN 37412-2720 Ph: (423) 867-4969 |
Dr. Judith J Boggess, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1508 Tombras Ave, East Ridge, TN 37412 Phone: 423-867-4969 Fax: 423-805-4213 | |
Dr. Saundra Annette Williams, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1508 Tombras Ave, East Ridge, TN 37412 Phone: 423-867-4969 Fax: 423-867-4971 |