1558544221 NPI number — R. ARUNACHALAM, MD, PC

Table of content: (NPI 1558544221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558544221 NPI number — R. ARUNACHALAM, MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R. ARUNACHALAM, MD, PC
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:
1558544221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 111055
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:
37222-1055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-942-7230
Provider Business Mailing Address Fax Number:
615-942-7237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
395 WALLACE RD
Provider Second Line Business Practice Location Address:
SUITE B301
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37211-4881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-942-7230
Provider Business Practice Location Address Fax Number:
615-942-7237
Provider Enumeration Date:
12/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARUNACHALAM
Authorized Official First Name:
R.
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
615-942-7230

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  MD0000039953 , 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: 33324051 . This is a "MEDICARE INDIVIDUAL PTAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 33324052 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1558544221 . This is a "GROUP NPI" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1467562611 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4169800 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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