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General NPI Number Information
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NPI Number | 1861495152
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Entity Type | Individual
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Provider Name | ROBERT J. POMPHREY MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 16615 HIGHWAY 104 N STE B
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City | LEXINGTON
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State | TN
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Zip | 38351-5753
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Country | US
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Telephone | 731-968-0660
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Fax | 731-968-0007
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Provider Business Mailing Address
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Address Line | 1014 BELL STORE RD
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City | GLEASON
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State | TN
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Zip | 38229-6418
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Country | US
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Telephone | 731-571-8960
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD29910
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License Number State | TN
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