Healthcare Provider Details

I. General information

NPI: 1679742423
Provider Name (Legal Business Name): AFFILIATED DERMATOLOGISTS OF GREEN HILLS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 HILLSBORO PIKE SUITE 200
NASHVILLE TN
37215-3345
US

IV. Provider business mailing address

4301 HILLSBORO PIKE STE 200
NASHVILLE TN
37215-3314
US

V. Phone/Fax

Practice location:
  • Phone: 615-383-6092
  • Fax: 615-292-8424
Mailing address:
  • Phone: 615-383-6092
  • Fax: 615-292-8424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD34844
License Number StateTN

VIII. Authorized Official

Name: CARLA RENEE' RETIEF
Title or Position: OWNER/MD
Credential: MD
Phone: 615-383-6092