| Gary A. Wishart, Psy.d., Pllc | |
|
601 Volunteer Pkwy Suite G Bristol TN 37620-3653 | |
| (423) 652-2212 | |
| (423) 652-2212 |
| Full Name | Gary A. Wishart, Psy.d., Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 601 Volunteer Pkwy, Bristol, Tennessee |
| Authorized Official Name and Position | Gary Austin Wishart (OWNER) |
| Authorized Official Contact | 4236522212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary A. Wishart, Psy.d., Pllc 601 Volunteer Pkwy Suite G Bristol TN 37620-3653 Ph: (423) 652-2212 | Gary A. Wishart, Psy.d., Pllc 601 Volunteer Pkwy Suite G Bristol TN 37620-3653 Ph: (423) 652-2212 |
| NPI Number | 1780948950 |
|---|---|
| Provider Enumeration Date | 07/02/2012 |
| Last Update Date | 07/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780948950 | NPI | - | NPPES |
| 0004551019 | Other | TN | AETNA |
| 00610001154 | Other | TN | UNITED HEALTHCARE |
| 104229 | Other | TN | VALUE OPTIONS |
| 0181971 | Other | TN | BLUE CROSS/BLUE SHIELD |
| 1982775821 | Other | TN | ALL INSURANCE CARRIERS AND MEDICARE |
| 085256 | Other | VA | ANTHEM OF VIRGINIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | P0000001915 (Tennessee) | Primary |
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