Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | MD0000043128 | TN |
NPI | 1164579967 |
---|---|
Provider Name | Thomas Babcock IV |
First Address | Nashville, TN 37209-2328 |
Second Address | Nashville, TN 37209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 09/08/2018 |