Organization
SUNSHINE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAWANDUS LOVETT BENNETT PA-C (CEO)
(615) 942-9271
Entity
Organization
Contact information
Practice address
801 E OLD HICKORY BLVD, STE 150, MADISON, TN 37115-4169
(615) 942-9271
Mailing address
PO BOX 160441, NASHVILLE, TN 37216-0441
(615) 942-9271
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1203
TN
Other
Enumeration date
01/22/2008
Last updated
01/22/2008
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