Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 47863 | TN |
NPI | 1013233816 |
---|---|
Provider Name | Dr. Kelsey B Dexter |
First Address | Jackson, TN 38302-0400 |
Second Address | Jackson, TN 38305-3618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 10/04/2018 |