Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 000000C51540 | CA |
Y | 204F00000X | Transplant Surgeon | 54678 | TN |
N | 208200000X | Surgeon | 54678 | TN |
N | 208600000X | Surgeon | 54678 | TN |
NPI | 1124108279 |
---|---|
Provider Name | Clarence E Foster Iii |
First Address | Nashville, TN 37203-1534 |
Second Address | Nashville, TN 37203-1534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 06/02/2017 |