Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD039710 | TN |
NPI | 1184603854 |
---|---|
Provider Name | Dr. Catherine Sipe Bottoms |
First Address | Smyrna, TN 37167-6807 |
Second Address | Smyrna, TN 37167-6807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 24/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1509789 | (05) | TN |
I43524 | (02) | TN |