Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MD09104 | TN |
NPI | 1184716599 |
---|---|
Provider Name | Thomas Powers |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2006 |
Last Update Date | 04/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E01472 | (02) |