MEDICARE: WEST TENNESSEE HAND CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0106X	Orthopaedic Hand Surgery Physician	MD0000021629	TN

General Provider Information

NPI Number	:	1023281896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST TENNESSEE HAND CENTER, PLLC

Provider Business Mailing Address
First Line	:	19 SECURITY DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3626
Country	:	US
Telephone Number	:	731-256-8300
Fax Number	:	731-256-8302

Provider Business Practice Location Address
First Line	:	19 SECURITY DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3626
Country	:	US
Telephone Number	:	731-256-8300
Fax Number	:	731-256-8302

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES KENNETH LANTER
Credential	:	M.D.
Telephone Number	:	731-256-8300

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	04/11/2008

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