Healthcare Provider Details

I. General information

NPI: 1770571176
Provider Name (Legal Business Name): BILL SEKULOVSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 W MAIN ST
FRANKLIN TN
37064-3786
US

IV. Provider business mailing address

2781 LAFAYETTE DR
THOMPSONS STATION TN
37179-9762
US

V. Phone/Fax

Practice location:
  • Phone: 615-591-4750
  • Fax: 615-794-0081
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42744
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: