Individual
PHILLIP LOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 MEDICAL CENTER DR, NASHVILLE, TN 37232-0004
(615) 322-5000
Mailing address
2905 SCHOOL SIDE WAY, LAWRENCEVILLE, GA 30044-7860
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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