Healthcare Provider Details

I. General information

NPI: 1841369675
Provider Name (Legal Business Name): CHRIS CERNOL PARDUE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 WHITE BRIDGE RD
NASHVILLE TN
37205-1411
US

IV. Provider business mailing address

3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US

V. Phone/Fax

Practice location:
  • Phone: 615-352-0011
  • Fax: 615-352-1752
Mailing address:
  • Phone: 615-851-6033
  • Fax: 615-851-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD13573
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: