Individual
DR. JEFFREY CARL FOSNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 NORTHCREST DR, SPRINGFIELD, TN 37172-3962
(615) 598-7633
(931) 762-6532
Mailing address
220 NORTHCREST DR, SPRINGFIELD, TN 37172-3962
(615) 598-7633
(931) 762-6532
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD14905
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000421
—
TN
01
—
4103229
BLUECROSS BLUESHIELD
TN
Enumeration date
05/24/2006
Last updated
11/20/2018
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