Healthcare Provider Details

I. General information

NPI: 1326032244
Provider Name (Legal Business Name): NATASHA LYNN BUTTS SIFFRARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 CLARKSVILLE PIKE STE &3729
NASHVILLE TN
37218-2201
US

IV. Provider business mailing address

3727 CLARKSVILLE PIKE STE &3729
NASHVILLE TN
37218-2201
US

V. Phone/Fax

Practice location:
  • Phone: 629-895-0080
  • Fax: 629-895-5389
Mailing address:
  • Phone: 629-895-0080
  • Fax: 629-895-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39243
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: