OrganizationActive
Revive MD
NPI 1700107547 · Obesity Medicine (Obstetrics & Gynecology) Physician · Brentwood, TN
Provider details
- NPI number
- 1700107547
- Entity type
- Organization
- Primary specialty
- Obesity Medicine (Obstetrics & Gynecology) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Daphne Lodge, President
- License
- 26575 (TN)
Practice location
1804 Williamson Ct
Suite 107
Brentwood, TN 37027-8170
Phone: (615) 690-6600
Fax: (615) 690-6604
Mailing address
1804 Williamson Ct
Brentwood, TN 37027-8170
Registry dates
- Enumerated
- 2010-06-16
- Last updated
- 2010-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.