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Individual

LARRY M FAUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 WEATHERLY DR, CLARKSVILLE, TN 37043-8943
(931) 648-1912
(931) 648-1277
Mailing address
515 STONECREST PKWY, STE 210, SMYRNA, TN 37167-6826
(615) 625-7112
(615) 625-7028

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD08258
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5440539
TN
Enumeration date
09/20/2005
Last updated
01/21/2013
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