Individual
CAROL L. MAGNUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 N MAIN ST, SUITE D, SHELBYVILLE, TN 37160-2303
(931) 685-4060
(931) 685-4062
Mailing address
1701 N MAIN ST, SUITE D, SHELBYVILLE, TN 37160-2303
(931) 685-4060
(931) 685-4062
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD0000015928
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3002741
MEDICARE
—
05
—
3008500
—
TN
Enumeration date
01/27/2006
Last updated
11/05/2009
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