Healthcare Provider Details

I. General information

NPI: 1831597905
Provider Name (Legal Business Name): TENNESSEE MOBILE DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2874 ELM HILL PIKE
NASHVILLE TN
37214-3718
US

IV. Provider business mailing address

3701 JARVIS AVE
SKOKIE IL
60076-4019
US

V. Phone/Fax

Practice location:
  • Phone: 615-891-7164
  • Fax: 615-891-7239
Mailing address:
  • Phone: 847-626-0800
  • Fax: 847-626-0819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEEM ABBASI
Title or Position: SECRETARY
Credential:
Phone: 615-891-7164