Larry Ernest Gerdom, PA-C
Physician Assistant in Nashville, TN. Individual provider (NPI-1).
NPI number1104900547
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1104900547
- Entity type
- Individual (NPI-1)
- Name
- Mr. Larry Ernest Gerdom
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA0000001329 | TN | Yes |
Practice location
333 Murfreesboro RdNashville, TN 37210-2834
Phone 615-248-1261 · Fax 615-248-1622
Mailing address
4010 Wellington CtOld Hickory, TN 37138-4657
Phone 615-758-0476 · Fax 615-248-1622
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