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General NPI Number Information
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NPI Number | 1205769155
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Entity Type | Organization
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Legal Business Name | JEFFERSON COSMETIC SURGERY CLINIC, PLLC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 739 PRESIDENT PL STE 120
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City | SMYRNA
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State | TN
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Zip | 37167-6845
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Country | US
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Telephone | 615-768-5003
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Fax |
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Provider Business Mailing Address
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Address Line | 5064 REPUBLIC AVE
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City | MURFREESBORO
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State | TN
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Zip | 37129-7674
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ALISHA JEFFERSON
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Credential | MD
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Telephone | 615-598-2600
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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