Smg Lab Pllc Idtf

NPI #1114180619 in Gallatin, Tennessee

Provider Information

NPI Number
1114180619
Entity Type
Organization
Organization Name
Smg Lab Pllc Idtf
Subpart
Yes (part of a larger organization)
Parent Organization
SUMNER MEDICAL GROUP PLLC
Primary Specialty
Clinical Medical Laboratory
Enumeration Date
Jul 3, 2008
Last Updated
Jul 3, 2008

Practice Location

Address
575 E BLEDSOE ST
Address 2
SUITE 7
ZIP Code
37066-3054
Phone
(615) 452-2511

Authorized Official

Name
DR. ALTON SID KING JR., MD
Title
MEDICAL DIRECTOR
Phone
(615) 230-8070

Specialties & Taxonomy Codes

Specialty
Clinical Medical Laboratory

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