Organization
MID SOUTH COMMUNITY PATHOLOGY
Active
Parent organization
COMMUNITY PATHOLOGY LABORATORY
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY PATHOLOGY LABORATORY
Authorized official
MR. MIKE THOMAS HALL (OFFICE MANAGER)
(931) 528-2836
Entity
Organization
Contact information
Practice address
1805 N JACKSON ST, SUITE 7, TULLAHOMA, TN 37388-2290
(931) 461-8871
(931) 461-8874
Mailing address
1805 N JACKSON ST, SUITE 7, TULLAHOMA, TN 37388-2290
(931) 461-8871
(931) 461-8874
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
1965
TN
Other
Enumeration date
11/23/2009
Last updated
01/08/2010
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