Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 101013 | MO |
N | 2080P0201X | Pediatric Allergist | 101013 | MO |
Y | 2080P0201X | Pediatric Allergist | 61834 | TN |
NPI | 1588680722 |
---|---|
Provider Name | Dr. Leonard B Bacharier |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
209810803 | (05) | MO |
ENROLLED | (05) | IL |