Healthcare Provider Details

I. General information

NPI: 1215918321
Provider Name (Legal Business Name): ALVIN H. MEYER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BLVD STE 509
HERMITAGE TN
37076-2054
US

IV. Provider business mailing address

5651 FRIST BLVD STE 509
HERMITAGE TN
37076-2054
US

V. Phone/Fax

Practice location:
  • Phone: 615-889-5172
  • Fax: 615-889-5172
Mailing address:
  • Phone: 615-889-5172
  • Fax: 615-889-5172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD8174
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD8174
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD8174
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD8174
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: