Individual
TIMOTHY E LASETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1771 MADISON ST, CLARKSVILLE, TN 37043-4990
(931) 552-6622
Mailing address
1000 RIVER RD, SUITE 100, CONSHOHOCKEN, PA 19428-2439
(800) 355-3818
(610) 834-2862
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1625
TN
207P00000X
Emergency Medicine Physician
Primary
N0199
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195010701
—
TX
05
—
195010702
—
TX
05
—
3300734
—
TN
01
—
8B8472
BCBS
TX
01
—
8X1238
BCBS
TX
01
—
P00651455
RAILROAD
TX
Enumeration date
06/10/2006
Last updated
02/02/2009
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