Larry Ernest Gerdom in Old Hickory - Physician Assistant
Larry Ernest Gerdom - NPI 1104900547
Larry Ernest Gerdom is a Physician Assistant in Old Hickory, Tennessee. Larry Ernest Gerdom practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Larry Ernest Gerdom is 1104900547. The last update date is 2007-07-08.
Larry Ernest Gerdom's current location address is 4010 Wellington Ct, Old Hickory, Tennessee. You can contact this provider via phone number 6157580476 and fax number 6152481622. The mailing address for Larry Ernest Gerdom is 4010 Wellington Ct, Old Hickory, Tennessee. To know further, please read the information below!
Provider Profile Detail
Provider Name | Larry Ernest Gerdom |
---|---|
Address | 4010 Wellington Ct, Old Hickory, Tennessee |
Phone Number | 6157580476 |
Fax Number | 6152481622 |
Sole Proprietor | N |
Credentials | PA-C |
NPI Number Detail
NPI Number | 1104900547 |
---|---|
Provider Enumeration Date | 2006-10-24 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 4010 Wellington Ct |
---|---|
City | Old Hickory |
State | Tennessee (TN) |
Post Code | 371384657 |
Phone Number | 6157580476 |
Fax Number | 6152481622 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
---|---|
Taxonomy | 363A00000X |
Licence No | PA0000001329 |
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
Post Comment/ Review Below
What is the Larry Ernest Gerdom's 1104900547?
The Larry Ernest Gerdom's NPI (National Provider Identifier) Number is 1104900547. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Larry Ernest Gerdom is geographically located?
The Larry Ernest Gerdom is physically situated at the following location: 4010 Wellington Ct, Old Hickory, TN, 371384657.
What is Larry Ernest Gerdom's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Larry Ernest Gerdom is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date did Larry Ernest Gerdom receive its 1104900547 assignment from the Centers for Medicare & Medicaid Services?
The Larry Ernest Gerdom was assigned its 1104900547 on 2006-10-24, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Larry Ernest Gerdom most recently updated or revised?
The details related to Larry Ernest Gerdom, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.