Provider Demographics
NPI:1013182260
Name:TENNESSEE PEDIATRICS P.C.
Entity Type:Organization
Organization Name:TENNESSEE PEDIATRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-550-4030
Mailing Address - Street 1:6640 CAROTHERS PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:615-550-4030
Mailing Address - Fax:615-550-4035
Practice Address - Street 1:100 SPRINGHOUSE COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-826-2080
Practice Address - Fax:615-550-4035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty