Healthcare Provider Details

I. General information

NPI: 1891850780
Provider Name (Legal Business Name): RICHLAND INTERNAL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 CROSSING CIRCLE SUITE 100
MT JULIET TN
37122
US

IV. Provider business mailing address

PO BOX 24730
NASHVILLE TN
37202-4730
US

V. Phone/Fax

Practice location:
  • Phone: 615-595-9111
  • Fax: 615-758-3791
Mailing address:
  • Phone: 615-386-2300
  • Fax: 615-386-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES P HOUSER
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 615-284-6861