Justin Wade Widner, DO

Pediatrics Physician · Tazewell, TN

Individual Active NPI

NPI number 1225566953

Practice location

1610 Tazewell Rd Ste 203
Tazewell, TN 37879-3648
Phone
(423) 259-3701
Fax
(866) 954-5783

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NPI record

NPI
1225566953
Entity type
Individual (Type 1)
Enumeration date
May 25, 2017
Last updated
April 8, 2022
Certified
April 8, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X 3903 TN

Mailing address

PO Box 15004
Knoxville, TN 37901-5004
Phone
(865) 541-8895
Fax
(865) 633-4808

About Dr. Widner

Justin Wade Widner, DO is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 1610 Tazewell Rd Ste 203, Tazewell, TN 37879-3648. The NPI number 1225566953 was assigned on May 25, 2017 and the record was last updated on April 8, 2022.

Dr. Widner lists a license in the registry: #3903 (TN) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Justin Wade Widner, DO?

The NPI number is 1225566953.

What is the phone number of Dr. Widner?

The phone number listed for the practice location is (423) 259-3701.

Where is Dr. Widner located?

1610 Tazewell Rd Ste 203, Tazewell, TN 37879-3648.

What is the taxonomy code for Dr. Widner?

The primary taxonomy code is 208000000X – Pediatrics Physician.

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.

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