Healthcare Provider Details

I. General information

NPI: 1841278413
Provider Name (Legal Business Name): JOHN KIRBY PATE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 INTERNATIONAL DR SUITE SUITE 240
FRANKLIN TN
37067-1761
US

IV. Provider business mailing address

109 INTERNATIONAL DR SUITE 240
FRANKLIN TN
37067-1761
US

V. Phone/Fax

Practice location:
  • Phone: 615-301-7000
  • Fax: 615-301-7001
Mailing address:
  • Phone: 615-567-6527
  • Fax: 615-567-6756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD12595
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: