Organization
SARAH MOON THELEN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH MOON THELEN MD (PHYSICIAN)
(931) 227-4984
Entity
Organization
Contact information
Practice address
305 COLLEGE ST W, FAYETTEVILLE, TN 37334-2911
(931) 227-4984
(931) 227-4985
Mailing address
2330 THORNTON TAYLOR PKWY, SUITE B, FAYETTEVILLE, TN 37334-3672
(931) 227-4984
(931) 227-4985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1522804
—
TN
Enumeration date
02/11/2011
Last updated
02/28/2023
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