1154333086 NPI number — TENNESSEE MATERNAL-FETAL MEDICINE LLC

Table of content: (NPI 1154333086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154333086 NPI number — TENNESSEE MATERNAL-FETAL MEDICINE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENNESSEE MATERNAL-FETAL MEDICINE LLC
Provider Last Name:
Provider First Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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NPI Number Information

NPI Number:
1154333086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2010 CHURCH ST
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-2012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-284-7833
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2010 CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-284-7833
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COLLINS
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
BRECK
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-284-7833

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)