Organization
CENTRAL TENNESSEE EAR NOSE & THROAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY M FOUST (OFFICE MANAGER)
(931) 647-1255
Entity
Organization
Contact information
Practice address
787 WEATHERLY DR, SUITE 200, CLARKSVILLE, TN 37043-8949
(931) 647-1255
(931) 647-2399
Mailing address
787 WEATHERLY DR, SUITE 200, CLARKSVILLE, TN 37043-8949
(931) 647-1255
(931) 647-2399
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000021029
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1524504
—
TN
01
—
6039651
BLUECROSS
—
01
—
621860059
TRICARE
TN
Enumeration date
08/18/2006
Last updated
12/10/2015
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