1386862266 NPI number — MATTHEW SPEYER, M.D., F.A.C.S.

Table of content: (NPI 1386862266)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386862266 NPI number — MATTHEW SPEYER, M.D., F.A.C.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MATTHEW SPEYER, M.D., F.A.C.S.
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:
1386862266
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:
3443 DICKERSON PIKE
Provider Second Line Business Mailing Address:
STE 320
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-865-7050
Provider Business Mailing Address Fax Number:
615-865-0775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3443 DICKERSON PIKE
Provider Second Line Business Practice Location Address:
STE 320
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37207-2519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-865-7050
Provider Business Practice Location Address Fax Number:
615-865-0775
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ENGLAND
Authorized Official First Name:
LEA ANN
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING COORDINATOR
Authorized Official Telephone Number:
615-865-7050

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  30582 , 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)

  • Identifier: GROUP . This is a "NPI" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com