Organization
STATE OF TENNESSEE
Active
Other names
Lake County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY W HARDEN (REGIONAL DIRECTOR)
(731) 421-6700
Entity
Organization
Contact information
Practice address
400 HWY 78 SOUTH, TIPTONVILLE, TN 38079
(731) 253-9954
(731) 253-9956
Mailing address
400 HWY 78 SOUTH, TIPTONVILLE, TN 38079
(731) 253-9954
(731) 253-9956
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4448142
—
TN
Enumeration date
01/11/2007
Last updated
09/01/2010
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