Organization
GETHSEMANE CARDIOVASCULAR CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL A JACKSON MD (OWNER)
(615) 494-1255
Entity
Organization
Contact information
Practice address
1602 W NORTHFIELD BLVD, SUITE 511 & 512, MURFREESBORO, TN 37129-6057
(615) 494-1255
(615) 896-0403
Mailing address
1602 WEST NORTHFIELD BOULEVARD, SUITE 511 & 512, MURFREESBORO, TN 37129-6057
(615) 494-1255
(615) 494-1274
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD38872
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD38872
MD LICENSE
TN
Enumeration date
08/05/2006
Last updated
06/11/2010
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