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NPI Code Detail

MEDICARE: DR. LOLA BLACKWELL CHAMBLESS MD

MEDICARE: DR. LOLA BLACKWELL CHAMBLESS 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
1207T00000XNeurological Surgery PhysicianMD0000048404TN

General Provider Information

NPI Number : 1811044704
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOLA BLACKWELL CHAMBLESS MD
Provider Business Mailing Address
First Line : 3841 GREEN HILLS VILLAGE DR STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-2691
Country : US
Telephone Number : 615-343-2452
Fax Number :
Provider Business Practice Location Address
First Line : 1161 21ST AVE S
Second Line : T-4224 MEDICAL CENTER NORTH
City : NASHVILLE
State : TN
Zip : 37232-0001
Country : US
Telephone Number : 615-343-2452
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 03/23/2022

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