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General NPI Number Information
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NPI Number | 1144517590
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Entity Type | Organization
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Legal Business Name | LUCY H. DIGMON
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 2845 N HOUSTON LEVEE RD SUITE 101
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City | CORDOVA
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State | TN
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Zip | 38016-0179
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Country | US
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Telephone | 901-266-0555
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Fax | 901-266-3921
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Provider Business Mailing Address
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Address Line | 2845 N HOUSTON LEVEE RD SUITE 101
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City | CORDOVA
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State | TN
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Zip | 38016-0179
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Country | US
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Telephone | 901-266-0555
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Fax | 901-266-3921
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUCY H DIGMON
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Credential | D.M.D.
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Telephone | 901-266-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8861
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License Number State | TN
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