Organization
OCTAVE TN MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDGEWORTH MD (SOLE MEMBER)
(615) 406-4994
Entity
Organization
Contact information
Practice address
912 STUART LN, BRENTWOOD, TN 37027-5822
(650) 459-0942
Mailing address
912 STUART LN, BRENTWOOD, TN 37027-5822
(615) 406-4994
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
07/18/2024
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