Healthcare Provider Details

I. General information

NPI: 1740677517
Provider Name (Legal Business Name): EVELEIGH WAGNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVELEIGH BYERS MD

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 RIVERSIDE DRIVE SUITE 460
FRANKLIN TN
37064-9000
US

IV. Provider business mailing address

381 RIVERSIDE DRIVE SUITE 460
FRANKLIN TN
37064-9000
US

V. Phone/Fax

Practice location:
  • Phone: 615-224-9800
  • Fax: 615-224-9840
Mailing address:
  • Phone: 615-244-9800
  • Fax: 615-224-9840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number59225
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number279934
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: