Organization
BRENTWOOD SKIN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES AUSTIN MITCHELL III MD (PRESIDENT/OWNER)
(615) 810-8730
Entity
Organization
Contact information
Practice address
5505 EDMONDSON PIKE, SUITE 10, NASHVILLE, TN 37211-5872
(615) 810-8730
(615) 810-8731
Mailing address
5505 EDMONDSON PIKE, SUITE 10, NASHVILLE, TN 37211-5872
(615) 810-8730
(615) 810-8731
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
37546
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
10/03/2013
Last updated
11/21/2017
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