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Organization
TENNESSEE MATERNAL FETAL MEDICINE PLC
Active
Organization
TENNESSEE MATERNAL FETAL MEDICINE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOLA CLARK (ADMINISTRATOR)
(615) 983-5404
Entity
Organization
Contact information
Practice address
404 N CASTLE HEIGHTS AVE, SUITE E, LEBANON, TN 37087-1511
(615) 983-5404
(615) 284-8637
Mailing address
300 20TH AVE N, SUITE 702, NASHVILLE, TN 37203-2131
(615) 284-8636
(615) 284-8637
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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