| NPI | 1235132879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JACKSON Senior Director Provider Enrollment 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-07-21 |