Provider Demographics
NPI:1891764874
Name:DYER, WILLIAM CARL JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CARL
Last Name:DYER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1604 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3125
Mailing Address - Country:US
Mailing Address - Phone:423-266-1808
Mailing Address - Fax:423-266-1800
Practice Address - Street 1:1301 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2934
Practice Address - Country:US
Practice Address - Phone:423-266-1808
Practice Address - Fax:423-266-1800
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN620961954207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2005642OtherBLUE CROSS BLUE SHIELD
TNMD0000005405OtherLISCENSE
GA015248OtherGEORGIA STATE LISCENSE
TNAD 4434596OtherDEA#
TN2005642OtherBLUE CROSS BLUE SHIELD
TN3152665Medicare ID - Type Unspecified