Healthcare Provider Details

I. General information

NPI: 1396730891
Provider Name (Legal Business Name): SUSAN R LIMBAUGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 CUMBERLAND BND
NASHVILLE TN
37228-1805
US

IV. Provider business mailing address

275 CUMBERLAND BND
NASHVILLE TN
37228-1805
US

V. Phone/Fax

Practice location:
  • Phone: 866-816-0433
  • Fax: 615-327-4818
Mailing address:
  • Phone: 615-726-3340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number37583
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: