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Individual

TERRELL LEE TEDFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
935 WAYNE RD, SAVANNAH, TN 38372
(731) 632-5577
Mailing address
PO BOX 562, ADAMSVILLE, TN 38310
(731) 632-5577
(732) 632-5577

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
051696
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3632567
TN
01
4057605
BCBS
TN
01
TN0101
AMERICHOICE
TN
Enumeration date
01/23/2007
Last updated
03/02/2020
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