Healthcare Provider Details

I. General information

NPI: 1972335099
Provider Name (Legal Business Name): RYAN COLEMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-0004
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number4009
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number4009
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: