Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD30045 | TN |
NPI | 1003830332 |
---|---|
Provider Name | Dr. Robert T Lim JR. |
First Address | Hendersonville, TN 37075-8730 |
Second Address | Goodlettsville, TN 37072-1925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 15/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3824318 | (05) | TN |
G82938 | (02) | TN |