| Organization Name: | LEBANON GENERAL PRACTICE INC |
| NPI Number: | 1659496040 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAWN JOHNSON (MEDICAL BILLING) |
| Mailing Address: | 1037 W Main St Suite A Lebanon |
| State: | TN US |
| Postal Code: | 370873355 |
| Phone Number: | 6154533567 |
| Fax Number: | 6154534031 |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 04/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 30964 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |