Individual
PETER THOMAS GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2075 PLEASANT PLAINS EXT RD, JACKSON, TN 38305-6087
(731) 984-8400
(731) 984-8305
Mailing address
PO BOX 12197, DEPT, JACKSON, TN 38308-0136
(731) 984-8400
(731) 984-8305
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD26391
TN
390200000X
Student in an Organized Health Care Education/Training Program
26391
TN
Other
Enumeration date
03/05/2007
Last updated
06/29/2011
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