Organization
PATH LAB OF MIDDLE TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D MICHAELSON M.D. (LABORATORY DIRECTOR)
(615) 396-4489
Entity
Organization
Contact information
Practice address
400 N HIGHLAND AVE, MURFREESBORO, TN 37130-3837
(615) 396-4489
Mailing address
PO BOX 1069, MADISON, TN 37116-1069
(615) 868-1266
(615) 868-1316
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25282
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006591
BLUE CROSS
TN
01
—
220015692
RAILROAD MEDICARE
TN
01
—
220015757
RAILROAD MEDICARE
TN
05
—
3032197
—
TN
01
—
3049004
BLUE CROSS
TN
05
—
3083843
—
TN
Enumeration date
01/31/2007
Last updated
08/10/2009
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