Individual
DR. GRETCHEN PURCELL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-5100
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 322-3573
(615) 936-6095
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD41269
TN
2086S0120X
Pediatric Surgery Physician
Primary
MD41269
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620476822
TAX ID
—
Enumeration date
06/27/2006
Last updated
03/18/2022
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