Healthcare Provider Details

I. General information

NPI: 1932129400
Provider Name (Legal Business Name): SEKOU F MOLETTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 MURPHY AVE SUITE 401
NASHVILLE TN
37203-1835
US

IV. Provider business mailing address

PO BOX 330760
NASHVILLE TN
37203-7505
US

V. Phone/Fax

Practice location:
  • Phone: 615-340-3436
  • Fax: 877-472-3945
Mailing address:
  • Phone: 615-340-3436
  • Fax: 877-472-3945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD31865
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD31865
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: