Organization
MID SOUTH PSYCHIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED I FAROOQUE MD (PARTNER)
(615) 895-8104
Entity
Organization
Contact information
Practice address
1830 HERITAGE PARK PLZ, MURFREESBORO, TN 37129-1575
(615) 895-8104
(615) 895-7903
Mailing address
1830 HERITAGE PARK PLZ, MURFREESBORO, TN 37129-1575
(615) 895-8104
(615) 895-7903
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
MD0000018343
TN
103TP0016X
Prescribing (Medical) Psychologist
Primary
MD0000020287
TN
1041C0700X
Clinical Social Worker
4196
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558479170
NPI
—
01
—
1861608895
NPI
—
01
—
1922116649
NPI
—
05
—
3706880
—
TN
Enumeration date
08/17/2007
Last updated
08/17/2007
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