Individual
DR. LAUREN RENE PANEZICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
102 S CHARLES G SEIVERS BLVD, CLINTON, TN 37716-3916
(865) 457-4702
(865) 374-2115
Mailing address
102 S CHARLES G SEIVERS BLVD, CLINTON, TN 37716-3916
(865) 457-4702
(865) 374-2115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59405
TN
207Q00000X
Family Medicine Physician
L.4372R
AL
207Q00000X
Family Medicine Physician
MD.36850
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q049891
—
TN
Enumeration date
11/18/2016
Last updated
01/10/2024
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