Organization
RIVERGATE DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH H. LOVEN (OWNER/LEAD DOCTOR)
(615) 859-7546
Entity
Organization
Contact information
Practice address
201 BLUEBIRD DR, GOODLETTSVILLE, TN 37072-2301
(615) 859-7546
(615) 851-7760
Mailing address
201 BLUEBIRD DR, GOODLETTSVILLE, TN 37072-2301
(615) 859-7546
(615) 851-7760
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MDO17949
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235116518
NPI #
TN
01
—
3708943
MEDICARE GROUP #
TN
Enumeration date
09/18/2007
Last updated
09/18/2007
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