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Individual

DR. SANFORD JONATHAN LAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1720 NASHVILLE PIKE STE 100, GALLATIN, TN 37066-3154
(615) 230-8601
(615) 230-8670
Mailing address
1720 NASHVILLE PIKE STE 100, GALLATIN, TN 37066-3154
(615) 230-8601
(615) 230-8670

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301407434
MI
207Q00000X
Family Medicine Physician
Primary
59735
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0806365081
BLUE CROSS OF MI
05
3454731
MI
Enumeration date
12/29/2005
Last updated
09/17/2019
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