Organization
CEDAR GROVE MEDICAL ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DANIEL RUDD MD (OWNER)
(615) 459-6700
Entity
Organization
Contact information
Practice address
301 WOLVERINE TRAIL, SUITE 100, SMYRNA, TN 37167
(615) 459-6700
(615) 459-0068
Mailing address
PO BOX 520, WEST PADUCAH, KY 42086-0520
(270) 744-0404
(270) 744-0606
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000012820
TN
Other
Enumeration date
06/11/2007
Last updated
04/04/2008
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