Provider Demographics
NPI:1881682011
Name:KATTINE, ALBERT (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:KATTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 MEDICAL CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2202
Mailing Address - Country:US
Mailing Address - Phone:615-867-8200
Mailing Address - Fax:615-867-8221
Practice Address - Street 1:1430 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2202
Practice Address - Country:US
Practice Address - Phone:615-867-8200
Practice Address - Fax:615-867-8221
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24568207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3080400Medicare ID - Type Unspecified
TNF72841Medicare UPIN