| NPI | 1619699667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY JACKSON Sr Director Of Provider Enrollment 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2022-09-15 |