Individual
MARK EDWIN FRISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3707 WIMBLEDON RD, NASHVILLE, TN 37215-1819
(615) 720-7761
(615) 936-0102
Mailing address
3707 WIMBLEDON RD, NASHVILLE, TN 37215-1819
(615) 720-7761
(615) 936-0102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R3A00
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R3A00
STATE LICENSURE
MO
Enumeration date
12/28/2016
Last updated
12/28/2016
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