Individual
DR. VIRGINIA A TEDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2535 MADISON ST, SUITE D, CLARKSVILLE, TN 37043-3920
(931) 368-1153
(931) 368-1150
Mailing address
2535 MADISON ST, SUITE D, CLARKSVILLE, TN 37043-3920
(931) 368-1153
(931) 368-1150
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
TN20448
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3072786
—
TN
01
—
4029755
BLUE CROSS BLUE SHIELD
TN
Enumeration date
08/25/2006
Last updated
07/08/2007
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