Memorial Drive Family Practice

NPI 1154318954 - Family Medicine - 207Q00000X

NPI Details
NPI 1154318954
Enumeration Date 10/05/2005
Last Updated 01/17/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name STEPHAN STEPHAN
Position PHYSICIAN
Phone (931) 648-1920
Fax (931) 503-0346
Practice Location
306 LANDRUM PL
CLARKSVILLE TN, 37043-4648, US
Phone (931) 648-1920
Fax (931) 503-0346
Business Location
PO BOX 3857
CLARKSVILLE TN, 37043-0857, US
Phone (931) 648-1920
Fax (931) 503-0346
Toxanomy
Taxonomy Code 207Q00000X
License State Tennessee
License Number D0769
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According to our database, Memorial Drive Family Practice NPI is 1154318954, taxonomy code is 207Q00000X and license number is D0769, license state is located at Tennessee. Memorial Drive Family Practice physically located at 306 Landrum Pl, Clarksville TN, 37043-4648. NPI Number 1033115704 has the healthcare provider type.

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1154318954 NPI number is provided on an as is basis without warranty of any kind. 1154318954 is maintained by the National Plan & Provider Enumeration System. The contents of Memorial Drive Family Practice are for informational purposes only.