Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 045766 | GA |
N | 208600000X | Surgeon | 045766 | GA |
N | 2086S0102X | Surgical Critical Care | 045766 | GA |
Y | 2086S0127X | Trauma Surgeon | 42773 | TN |
NPI | 1235139916 |
---|---|
Provider Name | Lemuel Dent |
First Address | Nashville, TN 37208-3501 |
Second Address | Nashville, TN 37208-2918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 09/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000839055 | (05) | GA |
H00876 | (02) |