Organization
PONTCHARTRAIN MEDICAL GROUP, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A CALARCO DO (CEO)
(615) 712-5862
Entity
Organization
Contact information
Practice address
200 POWELL PL, ATTN: LEGAL DEPARTMENT, BRENTWOOD, TN 37027-7514
(615) 732-1605
Mailing address
200 POWELL PL, ATTN: LEGAL DEPARTMENT, BRENTWOOD, TN 37027-7514
(615) 732-1605
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
03/29/2016
Last updated
08/25/2021
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