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General NPI Number Information
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NPI Number | 1306943832
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Entity Type | Individual
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Provider Name | DAVID MARTIN VANDERPOOL MD
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Gender | Male
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 5409 MARYLAND WAY STE 119
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City | BRENTWOOD
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State | TN
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Zip | 37027
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Country | US
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Telephone | 615-833-3002
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Fax | 615-221-1197
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Provider Business Mailing Address
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Address Line | 5409 MARYLAND WAY STE 119
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City | BRENTWOOD
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State | TN
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Zip | 37027
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Country | US
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Telephone | 615-833-3002
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Fax | 615-221-1197
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD0000023744
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License Number State | TN
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