Healthcare Provider Details

I. General information

NPI: 1063566156
Provider Name (Legal Business Name): HOSPITALISTS AT CENTENNIAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 11/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PATTERSON ST SUITE 311
NASHVILLE TN
37203-1562
US

IV. Provider business mailing address

2400 PATTERSON ST SUITE 311
NASHVILLE TN
37203-1562
US

V. Phone/Fax

Practice location:
  • Phone: 615-342-6830
  • Fax: 615-342-6836
Mailing address:
  • Phone: 615-342-6830
  • Fax: 615-342-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CHUCK LOCKE
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-373-7604