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NPI Code Detail

MEDICARE: DR. EVAN N WOLFE D.O.

MEDICARE: DR. EVAN N WOLFE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1477393718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVAN N WOLFE D.O.
Provider Business Mailing Address
First Line : 1001 HEALTH PARK DR STE 609
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 391 WALLACE RD
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-4851
Country : US
Telephone Number : 615-342-3964
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2024
Last Update Date : 06/02/2026

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