Provider Demographics
NPI:1477552263
Name:LATOUR, DANA L (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:LATOUR
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 1:740 COOL SPRINGS BLVD
Mailing Address - Street 2:#200
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6448
Mailing Address - Country:US
Mailing Address - Phone:615-771-1881
Mailing Address - Fax:615-771-0050
Practice Address - Street 1:740 COOL SPRINGS BLVD
Practice Address - Street 2:#200
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6448
Practice Address - Country:US
Practice Address - Phone:615-771-1881
Practice Address - Fax:615-771-0050
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11525207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN20353OtherBLUE CROSS BLUE SHIELD TN
TN3186209Medicare ID - Type Unspecified
TN20353OtherBLUE CROSS BLUE SHIELD TN