1467596080 NPI number — JOHN Q BINHLAM M.D.

Table of content: JOHN Q BINHLAM M.D. (NPI 1467596080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467596080 NPI number — JOHN Q BINHLAM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BINHLAM
Provider First Name:
JOHN
Provider Middle Name:
Q
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1467596080
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1649 WESTGATE CIR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-8573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-843-7546
Provider Business Mailing Address Fax Number:
615-777-3376

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1649 WESTGATE CIR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027-8019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-843-7546
Provider Business Practice Location Address Fax Number:
615-777-3376
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD0000024945 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , with the licence number: 024945 , 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: 51949393 . This is a "MULTIPLAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 6050644 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 070012873 . This is a "GBA RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1124001466 . This is a "NPI GROUP NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 363029 . This is a "USA MCO" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3076923 . This is a "BLUE CROSS SHIELD OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 6661701 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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