# TENNESSEE MATERNAL FETAL MEDICINE PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033467188
- **Authorized official:** LOLA CLARK (ADMINISTRATOR)
- **Authorized official phone:** (615) 983-5404

## Contact information

- **Practice address:** 404 N CASTLE HEIGHTS AVE, SUITE E, LEBANON, TN 37087-1511
- **Practice address phone:** (615) 983-5404
- **Practice address fax:** (615) 284-8637
- **Mailing address:** 300 20TH AVE N, SUITE 702, NASHVILLE, TN 37203-2131
- **Mailing address phone:** (615) 284-8636
- **Mailing address fax:** (615) 284-8637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2012
- **Last updated:** 08/21/2012