1184695942 NPI number — MR. ANDREW WRIGHT STANFIELD PT, DPT

Table of content: MR. ANDREW WRIGHT STANFIELD PT, DPT (NPI 1184695942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184695942 NPI number — MR. ANDREW WRIGHT STANFIELD PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STANFIELD
Provider First Name:
ANDREW
Provider Middle Name:
WRIGHT
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
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:
1184695942
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 ENCLAVE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37211-7464
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-803-3733
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 JACKSON MEADOWS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERMITAGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37076-1453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-677-6360
Provider Business Practice Location Address Fax Number:
334-768-6540
Provider Enumeration Date:
01/30/2006

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: 225100000X , with the licence number:  9018 , 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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