| NPI | 1093446551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Senior Director Provider Enrollment 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-08-11 |