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1164124541
DEREK WAKEFIELD
JACKSON, TN
NPI
1164124541
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-20
Last Update Date
2023-03-20
Business Address
DEREK WAKEFIELD DO
294 SUMMAR DR
JACKSON, TN 38301-3915
Phone number: 731-423-1932
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Mailing Address
DEREK WAKEFIELD DO
294 SUMMAR DR
JACKSON, TN 38301-3915
Phone number: 731-423-1932
Copy
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