Healthcare Provider Details

I. General information

NPI: 1285762500
Provider Name (Legal Business Name): S L FAULKNER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 WALLACE RD B BUILDING SUITE 101
NASHVILLE TN
37211-4851
US

IV. Provider business mailing address

600 AYLESFORD LN
FRANKLIN TN
37069-4108
US

V. Phone/Fax

Practice location:
  • Phone: 334-430-4646
  • Fax: 615-591-0528
Mailing address:
  • Phone: 615-595-1072
  • Fax: 615-595-1072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number41850
License Number StateTN

VIII. Authorized Official

Name: DR. SCOTT LEE FAULKNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 615-595-1072