MEDICARE: GARDNER MEDICAL SERVICE, LLC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1932767480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDNER MEDICAL SERVICE, LLC

Provider Business Mailing Address
First Line	:	4005 TRAVIS DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3704
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4005 TRAVIS DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3704
Country	:	US
Telephone Number	:	615-834-3123
Fax Number	:	615-834-3008

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN GARDNER
Credential	:	PA
Telephone Number	:	423-956-2202

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	06/01/2026

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