Provider Demographics
NPI:1295432284
Name:FICHTEL DERMATOLOGY PLLC
Entity type:Organization
Organization Name:FICHTEL DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:C
Authorized Official - Last Name:FICHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-905-4994
Mailing Address - Street 1:1909 MALLORY LN STE 302
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2843
Mailing Address - Country:US
Mailing Address - Phone:615-905-4994
Mailing Address - Fax:615-224-6950
Practice Address - Street 1:1909 MALLORY LN STE 302
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2843
Practice Address - Country:US
Practice Address - Phone:615-905-4994
Practice Address - Fax:615-224-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty