Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 39020000X | GA |
NPI | 1003078361 |
---|---|
Provider Name | Dr. Leah Marie Umphlett |
First Address | Brentwood, TN 37027-4384 |
Second Address | Brentwood, TN 37027-7513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 30/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q002941 | (05) | TN |