Organization
LANA S. BEAVERS, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANA SHARON BEAVERS M.D. (SINGLE MEMBER LLC)
(931) 684-8469
Entity
Organization
Contact information
Practice address
885 UNION ST, SUITE A, SHELBYVILLE, TN 37160-2607
(931) 684-8469
(931) 684-8472
Mailing address
885 UNION ST, SUITE A, SHELBYVILLE, TN 37160-2607
(931) 684-8469
(931) 684-8472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000008506
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE PROVIDER NUMBER PENDING
TN
Enumeration date
12/03/2008
Last updated
12/03/2008
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