Healthcare Provider Details

I. General information

NPI: 1194921296
Provider Name (Legal Business Name): CUMBERLAND BRAIN & SPINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5653 FRIST BLVD STE 731
HERMITAGE TN
37076-2066
US

IV. Provider business mailing address

5653 FRIST BLVD STE 731
HERMITAGE TN
37076-2066
US

V. Phone/Fax

Practice location:
  • Phone: 866-781-1772
  • Fax: 615-884-0009
Mailing address:
  • Phone: 866-781-1772
  • Fax: 615-884-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD0000036852
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number37636
License Number StateKY

VIII. Authorized Official

Name: DR. CHRISTOPHER TALEGHANI
Title or Position: OWNER-NEUROSURGEON
Credential: MD
Phone: 615-884-0001