MEDICARE: MS. JOAN ELIZABETH POPKIN PH.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
1	103T00000X	Psychologist	P002569	TN
2	103T00000X	Psychologist	32279	TX

General Provider Information

NPI Number	:	1326186453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN ELIZABETH POPKIN PH.D.

Provider Business Mailing Address
First Line	:	230 CARDEN AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2422
Country	:	US
Telephone Number	:	615-496-3483
Fax Number	:	615-385-1676

Provider Business Practice Location Address
First Line	:	5364 VILLAGE WAY
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-6234
Country	:	US
Telephone Number	:	615-573-8069
Fax Number	:	615-333-0676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	05/03/2008

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