1053543934 NPI number — TENNESSEE WOMENS HEALTH CARE P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053543934 NPI number — TENNESSEE WOMENS HEALTH CARE P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENNESSEE WOMENS HEALTH CARE P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053543934
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 HARTMAN DR STE G-106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37087-2569
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-547-1160
Provider Business Mailing Address Fax Number:
615-547-1160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
404 N CASTLE HEIGHTS AVE STE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37087-1512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-547-1160
Provider Business Practice Location Address Fax Number:
615-547-1162
Provider Enumeration Date:
08/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CADENA
Authorized Official First Name:
ALBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
615-547-1160

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD0000031626 , 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)





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