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Individual

PATRICIA RENEE OBI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
168 W UNIVERSITY PKWY, STE A&B, JACKSON, TN 38305-1624
(731) 512-0043
(731) 512-0015
Mailing address
168 W UNIVERSITY PKWY, STE A&B, JACKSON, TN 38305-1624
(731) 512-0043
(731) 512-0015

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
017895
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3377799
TN
01
621861114
TAX ID
TN
Enumeration date
05/23/2005
Last updated
03/18/2010
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