Provider Demographics
NPI:1285762500
Name:S L FAULKNER MD PC
Entity type:Organization
Organization Name:S L FAULKNER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FAULKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-595-1072
Mailing Address - Street 1:600 AYLESFORD LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4108
Mailing Address - Country:US
Mailing Address - Phone:615-595-1072
Mailing Address - Fax:615-595-1072
Practice Address - Street 1:391 WALLACE RD
Practice Address - Street 2:B BUILDING SUITE 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4851
Practice Address - Country:US
Practice Address - Phone:334-430-4646
Practice Address - Fax:615-591-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41850207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN30010401Medicare PIN
ALC76360Medicare UPIN