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Individual

JAMES T ETTIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
397 WALLACE RD, SUITE C414, NASHVILLE, TN 37211-8022
(615) 781-9499
(615) 781-3882
Mailing address
397 WALLACE RD, SUITE C414, NASHVILLE, TN 37211-8022
(615) 781-9499
(615) 781-3882

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
41425
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3833106
TN
Enumeration date
10/04/2006
Last updated
04/24/2019
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