Individual
DR. ANTHONY VERNON DALLAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 INDIAN LAKE BLVD, SUITE A, HENDERSONVILLE, TN 37075-6214
(615) 826-3100
(615) 447-1059
Mailing address
211 INDIAN LAKE BLVD, SUITE A, HENDERSONVILLE, TN 37075-6214
(615) 826-3100
(615) 447-1059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16926
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517861
—
TN
Enumeration date
06/19/2006
Last updated
08/10/2015
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