Provider Demographics
NPI:1326032244
Name:BUTTS SIFFRARD, NATASHA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:LYNN
Last Name:BUTTS SIFFRARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3784
Mailing Address - Country:US
Mailing Address - Phone:615-794-1542
Mailing Address - Fax:615-790-5967
Practice Address - Street 1:1324 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3784
Practice Address - Country:US
Practice Address - Phone:615-794-1542
Practice Address - Fax:615-790-5967
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39243207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3330746Medicare ID - Type Unspecified
TNI33352Medicare UPIN