Healthcare Provider Details

I. General information

NPI: 1679581433
Provider Name (Legal Business Name): TENNESSEE MEDICINE & PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 PRESIDENT PLACE SUITE 200
SMYRNA TN
37167
US

IV. Provider business mailing address

741 PRESIDENT PLACE SUITE 200
SMYRNA TN
37167
US

V. Phone/Fax

Practice location:
  • Phone: 615-459-7104
  • Fax: 615-459-7822
Mailing address:
  • Phone: 615-459-7104
  • Fax: 615-459-7822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW L PERKINS
Title or Position: PRESIDENT
Credential: MD
Phone: 615-459-7104