Organization
MADISON PSYCHIATRIC ASSTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. A K M FAKHRUDDIN M.D. (PRESIDENT)
(615) 859-6414
Entity
Organization
Contact information
Practice address
803 MEADOWLARK LN, GOODLETTSVILLE, TN 37072-2307
(615) 859-6414
(615) 859-6419
Mailing address
803 MEADOWLARK LN, GOODLETTSVILLE, TN 37072-2307
(615) 859-6414
(615) 859-6419
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3730751
—
TN
Enumeration date
02/20/2007
Last updated
08/22/2020
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