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NPI Profile for PONTCHARTRAIN MEDICAL GROUP A PROFESSIONAL CORPORATION in BRENTWOOD, TN.
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine | |
Addiction Medicine |
207RA0401X | 11 | Physician/Internal Medicine |
| NPI # | 1356704357 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/29/2016 | |
| Last updated | 08/25/2021 - About 5 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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PONTCHARTRAIN MEDICAL GROUP, A PROFESSIONAL CORPORATION