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Organization
LIFE LONG FAMILY PRACTICE, PLLC
Active
Organization
LIFE LONG FAMILY PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS K PARDUE M.D. (OWNER)
(615) 871-0555
Entity
Organization
Contact information
Practice address
204 HIGHWAY 52 BYP W, LAFAYETTE, TN 37083-1727
(615) 688-7353
(615) 688-7355
Mailing address
3810 CENTRAL PIKE, SUITE 201, HERMITAGE, TN 37076-3494
(615) 871-0555
(615) 871-9398
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/23/2010
Last updated
10/28/2010
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