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Specialty details in registry · Antioch, TN

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At a glance

409 Barkley Ct, Antioch, TN 37013-4224

NPPES record updated May 23, 2016. Public records can lag behind changes at a practice.

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Practice location

409 Barkley Ct
Antioch, TN 37013-4224

Professional details: NPI, taxonomy & registry record

NPI1033566864

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 335E00000X
Enumeration date: May 23, 2016
Record updated: May 23, 2016

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

335E00000X · Primary

License reported: 192052 TN

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

409 Barkley Ct
Antioch, TN 37013-4224

Phone: (615) 474-1022

Mailing address

409 BARKLEY CT

ANTIOCH, TN 370134224

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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