Organization
NEW SOUTH MEDICAL
Active
Parent organization
NEW SOUTH MEDICAL
Other names
Women's Health Center of Clarksville
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW SOUTH MEDICAL
Authorized official
LISA M MCINTOSH M.D. (PHYSICIAN)
(931) 645-5595
Entity
Organization
Contact information
Practice address
2292 DALTON DR, SUITE C, CLARKSVILLE, TN 37043-8960
(931) 645-5595
(931) 645-5596
Mailing address
2292 DALTON DR, SUITE C, CLARKSVILLE, TN 37043-8960
(931) 645-5595
(931) 645-5596
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29433
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024236
LICENSE
TN
01
—
29433
MEDICAL LICENSE
TN
Enumeration date
02/10/2015
Last updated
02/10/2015
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