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Individual

DR. PETER GAGNON STIMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
901 GROVE ST, LOUDON, TN 37774-1509
(865) 458-8929
(865) 458-9412
Mailing address
901 GROVE ST, LOUDON, TN 37774-1509
(865) 458-8929
(865) 458-9412

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
8483
TN
208D00000X
General Practice Physician
Primary
8483
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3157385
TN
Enumeration date
08/11/2006
Last updated
06/30/2010
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