Benjamin M. Willy, ATC

Athletic Trainer · Jasper, TN

Individual Active NPI

NPI number 1164854303

Practice location

4150 Main St
Jasper, TN 37347-3445
Phone
(423) 942-8073
Fax
(423) 942-6660

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NPI record

NPI
1164854303
Entity type
Individual (Type 1)
Enumeration date
July 30, 2013
Last updated
May 13, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X 2056 TN
Athletic Trainer 2255A2300X AT 558 AR

Mailing address

8823 Production Ln
Ooltewah, TN 37363-6511
Phone
(423) 238-7217
Fax
(423) 238-3473

About Benjamin Willy

Benjamin M. Willy, ATC is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 4150 Main St, Jasper, TN 37347-3445. The NPI number 1164854303 was assigned on July 30, 2013 and the record was last updated on May 13, 2016.

Benjamin Willy lists 2 licenses in the registry: #2056 (TN) for Athletic Trainer; #AT 558 (AR) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Benjamin M. Willy, ATC?

The NPI number is 1164854303.

What is the phone number of Benjamin Willy?

The phone number listed for the practice location is (423) 942-8073.

Where is Benjamin Willy located?

4150 Main St, Jasper, TN 37347-3445.

What is the taxonomy code for Benjamin Willy?

The primary taxonomy code is 2255A2300X – Athletic Trainer; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.