Healthcare Provider Details

I. General information

NPI: 1689762684
Provider Name (Legal Business Name): ISHRAT JAMAL ANSARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALVIN C YORK 3400 LEBANON PIKE
MURFREESBORO TN
37129
US

IV. Provider business mailing address

1191 BLAKE COURT
MURFREESBORO TN
37130
US

V. Phone/Fax

Practice location:
  • Phone: 615-867-6000
  • Fax:
Mailing address:
  • Phone: 615-867-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD0000035338
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: