Antique, Julie Tan

Antique, Julie Tan is an individual health care provider with primary practice located at 620 Skyline Dr , Jackson TN 38301-3923. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Antique, Julie Tan can be contacted via phone (731) 541-6472.

Contact Information

Primary practice address
620 Skyline Dr Jackson TN 38301-3923
Phone: (731) 541-6472
Fax: (731) 541-3188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 38425 Tennessee

Profile Details

NPI number 1982623591
LBN Legal business name Antique, Julie Tan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Feb 10th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982623591 NPPES
Tennessee MEDICAID 3326081
Tennessee Other 4097479
Tennessee Other P00179539
Tennessee Other P00181736
Tennessee MEDICAID 3326089

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