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NPI Code Detail

MEDICARE: JULIE M PENA M.D.

MEDICARE: JULIE M PENA M.D.
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
1207ND0101XMOHS-Micrographic Surgery PhysicianMD0000033935TN
2207ND0900XDermatopathology Physician33935TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13159356OTHERTNBCBS

General Provider Information

NPI Number : 1184608416
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE M PENA M.D.
Provider Business Mailing Address
First Line : 200 COOL SPRINGS BLVD
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-2677
Country : US
Telephone Number : 615-771-7546
Fax Number : 615-771-8600
Provider Business Practice Location Address
First Line : 200 COOL SPRINGS BLVD
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-2677
Country : US
Telephone Number : 615-771-7546
Fax Number : 615-771-8600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 06/09/2014

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