Organization
INGRAM CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK BUCARAT (CEO)
(615) 946-2730
Entity
Organization
Contact information
Practice address
367 RIVERSIDE DR, FRANKLIN, TN 37064-8984
(615) 946-2730
Mailing address
367 RIVERSIDE DR, FRANKLIN, TN 37064-8984
(615) 946-2730
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
31548
TN
Other
Enumeration date
08/01/2012
Last updated
09/18/2012
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