Individual
LORI A DEITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3601 TVC, NASHVILLE, TN 37232-0001
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 322-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20559
TN
2085R0202X
Diagnostic Radiology Physician
ME86949
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000960825A
—
GA
05
—
265238200
—
FL
01
—
300135205
RAILROAD MEDICARE
FL
Enumeration date
02/16/2006
Last updated
03/30/2022
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