Individual
RAFAEL MARIO SANCHEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
641 RB WILSON DR, SUITE G, HUNTINGDON, TN 38344
(731) 986-7400
(731) 986-7402
Mailing address
P.O. BOX 405827, ATLANTA, GA 30384-5827
(901) 227-4068
(901) 227-4001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
947
TN
207Q00000X
Family Medicine Physician
0947
TN
207Q00000X
Family Medicine Physician
Primary
947
TN
207Q00000X
Family Medicine Physician
D00000947
TN
207Q00000X
Family Medicine Physician
OS5820
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3733244
—
TN
01
—
P00694510
RR MEDICARE
TN
Enumeration date
11/30/2006
Last updated
04/24/2016
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