National Provider Identifier Database

PROACTIVE MD LLC
Pulmonary Diagnostics

Included in the area of pulmonary diagnostics are the following; collection and analysis of physiological specimens, interpretation of physiological data, administration of tests of the cardiopulmonary system, and the conduct of both neurophysiological and sleep disorders studies.


Contact Information

PROACTIVE MD, LLC
2148 AZTEC DR
DYERSBURG, TN38024-1841
Phone: 731-589-6156
Fax: 615-467-8971
Website:
Specialty Taxonomy Code
* Pulmonary Diagnostics 2279P1004X

* Indicates primary specialty

NPI Profile & details for PROACTIVE MD, LLC

NPI Number 1326346412
Legal business name
LBN
PROACTIVE MD, LLC
Authorized official PHILLIP TIDWELL - (REGISTERED RESPIRATORY THERAPIST)
Entity Organization
Organization subpart No
Enumeration date 03/14/2011
Last updated 06/12/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: RRT0000000395

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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