NPI | 1386382273 |
---|---|
Entity Type | Organization |
Authorized Contact | DEREK KEITH JOHNSON CEO 615-785-9303 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2022-05-22 |
Last Update Date | 2023-11-30 |