Individual
DR. MICHAEL S LADOUCEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5651 FRIST BLVD, SUITE 200, HERMITAGE, TN 37076-2054
(615) 885-0200
(615) 885-0267
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 296-9939
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD0000031901
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD000031901
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3842887
—
TN
01
—
4342767
BCBS
TN
Enumeration date
10/12/2005
Last updated
05/10/2017
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