1407004211 NPI number — LINDA A FOSTER MD PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407004211 NPI number — LINDA A FOSTER MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINDA A FOSTER MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407004211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1540 APPLING CARE LN STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORDOVA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38016-4947
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-444-3950
Provider Business Mailing Address Fax Number:
901-444-3866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1589 SPARTA ST
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
MC MINNVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-815-0050
Provider Business Practice Location Address Fax Number:
931-815-0040
Provider Enumeration Date:
09/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
TIMOTHY
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
901-751-0939

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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