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General NPI Number Information
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NPI Number | 1073781217
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Entity Type | Organization
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Legal Business Name | BADRU, INC
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 521 W MAIN ST
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City | LEBANON
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State | TN
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Zip | 37087-3460
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Country | US
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Telephone | 615-547-6200
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Fax | 615-547-6202
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Provider Business Mailing Address
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Address Line | PO BOX 1214
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City | LEBANON
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State | TN
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Zip | 37088-1214
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Country | US
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Telephone | 615-547-6200
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Fax | 615-547-6202
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Authorized Official
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Title or Position | MD/OWNER OF BADRU, INC
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Name | ALEXANDER O BADRU
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Credential | MD
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Telephone | 615-547-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 41138
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License Number State | TN
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