Healthcare Provider Details

I. General information

NPI: 1023281896
Provider Name (Legal Business Name): WEST TENNESSEE HAND CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SECURITY DR
JACKSON TN
38305-3626
US

IV. Provider business mailing address

19 SECURITY DR
JACKSON TN
38305-3626
US

V. Phone/Fax

Practice location:
  • Phone: 731-256-8300
  • Fax: 731-256-8302
Mailing address:
  • Phone: 731-256-8300
  • Fax: 731-256-8302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD0000021629
License Number StateTN

VIII. Authorized Official

Name: JAMES KENNETH LANTER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 731-256-8300