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NPI Code Detail

MEDICARE: LUCIE CALDERON MD

MEDICARE: LUCIE CALDERON MD
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
1207RG0100XGastroenterology Physician73436TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730649104
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCIE CALDERON MD
Provider Business Mailing Address
First Line : PO BOX 381468
Second Line :
City : GERMANTOWN
State : TN
Zip : 38183-1468
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5653 FRIST BLVD STE 530
Second Line :
City : HERMITAGE
State : TN
Zip : 37076-2067
Country : US
Telephone Number : 615-885-1093
Fax Number : 615-885-1110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2019
Last Update Date : 02/03/2026

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