Dennis Small
Individual provider Active NPI Driver · Lakeland, TN
NPI 1366917650 · NPPES record last updated Oct 12, 2018
Key facts
- NPI
- 1366917650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 9160 Highway 64 Ste 12-187
Lakeland, TN 38002-4766 - Phone
- (901) 205-9032
- Fax
- (901) 292-9032
- NPI assigned
- Oct 12, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
9160 Highway 64 Ste 12-187
Lakeland, TN 38002-4766
Mailing address
9160 Highway 64 Ste 12-187
Lakeland, TN 38002-4766
Phone (901) 205-9032
Other providers in Lakeland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.