Individual
HEATHER TAILLAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
335 W SPRING ST, COOKEVILLE, TN 38501-3125
(504) 842-3000
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 759-3196
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
66276
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q078896
—
TN
Enumeration date
04/07/2016
Last updated
02/09/2023
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