Healthcare Provider Details

I. General information

NPI: 1629939244
Provider Name (Legal Business Name): PREMIER PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 N MAPLE ST
LEBANON TN
37087-2706
US

IV. Provider business mailing address

324 N MAPLE ST
LEBANON TN
37087-2706
US

V. Phone/Fax

Practice location:
  • Phone: 615-547-4205
  • Fax: 615-807-3303
Mailing address:
  • Phone: 615-547-4205
  • Fax: 615-807-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DORIAN CHAMPION
Title or Position: PRESIDENT
Credential:
Phone: 615-339-1288