Individual
DR. LUPO TANJUAKIO CARLOTA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9749 GREEN SPRUCE DR, LAKELAND, TN 38002-9341
(901) 821-8595
Mailing address
9749 GREEN SPRUCE DR, LAKELAND, TN 38002-9341
(901) 828-4795
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD0000012972
TN
Other
Enumeration date
06/01/2006
Last updated
08/05/2021
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