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NPI Code Detail

MEDICARE: DR. PHAYTHOUNE CHOTHMOUNETHINH M.D.

MEDICARE: DR. PHAYTHOUNE CHOTHMOUNETHINH M.D.
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
1207Q00000XFamily Medicine Physician80815AZ
2207Q00000XFamily Medicine Physician46218TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871770123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHAYTHOUNE CHOTHMOUNETHINH M.D.
Provider Business Mailing Address
First Line : 300 20TH AVE N STE 403
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-2131
Country : US
Telephone Number : 629-888-5175
Fax Number : 629-888-5176
Provider Business Practice Location Address
First Line : 114 SAUNDERSVILLE RD
Second Line :
City : HENDERSONVILLE
State : TN
Zip : 37075-8967
Country : US
Telephone Number : 629-888-5175
Fax Number : 629-888-5176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2008
Last Update Date : 03/12/2020

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