1467591800 NPI number — DOUGLAS C. YORK, M.D.

Table of content: (NPI 1467591800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467591800 NPI number — DOUGLAS C. YORK, M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOUGLAS C. YORK, M.D.
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:
1467591800
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:
2019 N CAROTHERS RD
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-5822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-591-4040
Provider Business Mailing Address Fax Number:
615-591-4411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2019 N CAROTHERS RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37067-5822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-591-4040
Provider Business Practice Location Address Fax Number:
615-591-4411
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YORK
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-591-4040

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD7790 , 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: 0184268 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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