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General NPI Number Information
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NPI Number | 1205270568
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Entity Type | Organization
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Legal Business Name | SUMNER PHYSICIAN PRACTICES LLC
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 10/13/2024
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Provider Practice Location Address
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Address Line | 225 BIG STATION CAMP BLVD
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City | GALLATIN
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State | TN
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Zip | 37066-8464
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Country | US
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Telephone | 615-328-3380
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Fax | 615-328-3381
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Provider Business Mailing Address
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Address Line | PO BOX 336
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City | GALLATIN
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State | TN
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Zip | 37066-0336
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Country | US
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Telephone | 615-328-3380
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Fax | 615-328-3381
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Authorized Official
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Title or Position | SECRETARY
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Name | CHARLOTTE LAWRENCE
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Credential |
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Telephone | 615-920-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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