Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD28203 | TN |
N | 207XS0117X | Orthopaedic Spine Surgeon | MD28203 | TN |
NPI | 1356342646 |
---|---|
Provider Name | Dr. Gray Clark Stahlman |
First Address | Nashville, TN 37204-3708 |
Second Address | Nashville, TN 37209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 30/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G31002 | (02) | TN |