Healthcare Provider Details

I. General information

NPI: 1598855934
Provider Name (Legal Business Name): KEITH ALLEN CARUSO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9005 OVERLOOK BLVD
BRENTWOOD TN
37027-8612
US

IV. Provider business mailing address

9005 OVERLOOK BLVD
BRENTWOOD TN
37027-8612
US

V. Phone/Fax

Practice location:
  • Phone: 615-236-1119
  • Fax: 615-236-1272
Mailing address:
  • Phone: 615-236-1119
  • Fax: 615-236-1272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD0000032067
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD0000032067
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: