Individual provider · NPI-1

Daisy Tan Antique, MD

Internal Medicine · Jackson, TN

NPI number1447227939
StatusActive
Last updated in NPPESDec 11, 2007

Details

NPI
1447227939
Entity type
Individual (NPI-1)
Name
Daisy Tan Antique
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Mar 2, 2006
Last updated
Dec 11, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine39516TNYes

Practice location

708 W Forest Ave
Jackson, TN 38301-3901

Phone 731-660-8759 · Fax 731-660-8739

Mailing address

1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436

Phone 731-660-8759 · Fax 731-660-8739

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine providers in Jackson, TN