Provider Demographics
NPI:1184779316
Name:WERNER, ALAN MEYER (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:MEYER
Last Name:WERNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 DUNLOP LN STE 203
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5165
Mailing Address - Country:US
Mailing Address - Phone:931-502-3700
Mailing Address - Fax:931-502-3705
Practice Address - Street 1:647 DUNLOP LN STE 203
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5165
Practice Address - Country:US
Practice Address - Phone:931-502-3700
Practice Address - Fax:931-502-3705
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD30526208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3830147Medicaid
TNG37805Medicare UPIN
TN3830147Medicare ID - Type Unspecified