Provider Demographics
NPI:1972615946
Name:SUSAN DONAGHEY MD APMC
Entity type:Organization
Organization Name:SUSAN DONAGHEY MD APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:I
Authorized Official - Last Name:DONAGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-904-0134
Mailing Address - Street 1:1819 WARD DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0567
Mailing Address - Country:US
Mailing Address - Phone:615-904-0134
Mailing Address - Fax:
Practice Address - Street 1:1819 WARD DR STE 101
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0567
Practice Address - Country:US
Practice Address - Phone:615-904-0134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40750261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735187Medicare ID - Type Unspecified