Basic Information
| Provider Information | |||||||||
| NPI: | 1609351865 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ATTENTIVE PSYCHIATRY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 519 PEABODY GREEN CV | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381044078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018210338 | ||||||||
| FaxNumber: | 9015078298 | ||||||||
| Practice Location | |||||||||
| Address1: | 9485 CRESTWYN HILLS CV | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381258515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016073001 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2018 | ||||||||
| LastUpdateDate: | 10/03/2018 | ||||||||
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| AuthorizedOfficialLastName: | TRAUTMAN | ||||||||
| AuthorizedOfficialFirstName: | LUCAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9016073001 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.