Provider Demographics
NPI:1578535936
Name:DOCTORS OFFICE LLC
Entity Type:Organization
Organization Name:DOCTORS OFFICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-443-0436
Mailing Address - Street 1:1430 BADDOUR PARKWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2514
Mailing Address - Country:US
Mailing Address - Phone:615-453-3645
Mailing Address - Fax:615-453-2675
Practice Address - Street 1:1430 BADDOUR PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2514
Practice Address - Country:US
Practice Address - Phone:615-453-3645
Practice Address - Fax:615-453-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3381171Medicaid
OTH000Medicare UPIN
TN3381171Medicaid