Female

Julie T. Antique MD

Infectious Disease Physician in Jackson, TN(View on Map)

Full Name

Julie Tan Antique MD

NPI Number

1982623591

NPI Type

Individual Provider

Gender

Female

Enumeration Date

07/18/2006

Specialties

(Taxonomies)

Code

207RI0200X

Primary Taxonomy

Yes

Licenses

State

Tennessee

License Number

38425

Contact
Information

Purpose

Mailing
Location

Address

620 SKYLINE DR
620 SKYLINE DR

City

Jackson
Jackson

State

TN
TN

Postal Code

38301-3923
38301-3923

Country

US
US

Telephone Number

(731) 541-6472
(731) 541-6472

Identifiers

Identifier

3326081
4097479
P00179539
P00181736
3326089

Identifier State

TN
Unknown
Unknown
TN
TN

Identifier Issuer

Unknown
BCBS
RR MEDICARE
RR MEDICARE
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/10/2010

Provider Address

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Melissa Appleton MD

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