Organization
CHILDRENS MEDICAL GROUP
Active
Other names
Children's Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH FAIRBANK MD (PRESIDENT)
(615) 883-2200
Entity
Organization
Contact information
Practice address
3786 CENTRAL PIKE STE 130, HERMITAGE, TN 37076-3498
(615) 883-2200
(615) 883-1104
Mailing address
3786 CENTRAL PIKE STE 130, HERMITAGE, TN 37076-3498
(615) 883-2200
(615) 883-1104
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517825
—
TN
Enumeration date
02/14/2006
Last updated
05/29/2020
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