Justice, Larry T

Justice, Larry T is an individual health care provider with primary practice located at 80 Vermont Ave , Oak Ridge TN 37830-6474. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Justice, Larry T can be contacted via phone (865) 482-4078.

Contact Information

Primary practice address
80 Vermont Ave Oak Ridge TN 37830-6474
Phone: (865) 482-4078
Fax: (865) 482-4960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 40574 Tennessee
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 40574 Tennessee

Profile Details

NPI number 1790721819
LBN Legal business name Justice, Larry T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Sep 18th, 2020 - about 5 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 1790721819 NPPES
Tennessee MEDICAID 3338151
Tennessee Other 4125100
Tennessee Other 7100065540
Tennessee MEDICAID Q009959
Tennessee MEDICAID 3379860

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