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General NPI Number Information
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NPI Number | 1073585774
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Entity Type | Organization
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Legal Business Name | PATHOLOGY ASSOCIATES OF ST. THOMAS
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 4220 HARDING RD
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City | NASHVILLE
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State | TN
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Zip | 37205-2005
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Country | US
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Telephone | 615-222-6756
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Fax | 615-222-6883
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Provider Business Mailing Address
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Address Line | PO BOX 30309
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City | CHARLESTON
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State | SC
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Zip | 29417-0309
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Country | US
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Telephone | 843-554-9300
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Fax | 843-566-8780
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD CLAYTON MCDONALD
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Credential | M.D,
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Telephone | 615-222-6756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 39425
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 8814
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 20647
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207ZM0300X
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Taxonomy Name | Medical Microbiology Physician
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License Number | 8773
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 8814
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License Number State | TN
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