Healthcare Provider Details

I. General information

NPI: 1780891903
Provider Name (Legal Business Name): DEERWOOD ULTRASOUND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1667 PRESTON PL
BRENTWOOD TN
37027-8660
US

IV. Provider business mailing address

1667 PRESTON PL
BRENTWOOD TN
37027-8660
US

V. Phone/Fax

Practice location:
  • Phone: 615-594-8601
  • Fax:
Mailing address:
  • Phone: 615-594-8601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ERNEST ISADORE GAUTHIER
Title or Position: CO-OWNER CEO
Credential:
Phone: 615-594-8601