Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2073 | TN |
Y | 207RP1001X | Pulmonary Disease | 2073 | TN |
N | 2080P0203X | Pediatric Critical Care Doctor | DO2073 | TN |
NPI | 1215900980 |
---|---|
Provider Name | Otis B Rickman |
First Address | Nashville, TN 37204-3609 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G97391 | (02) |