Healthcare Provider Details

I. General information

NPI: 1174255665
Provider Name (Legal Business Name): MUSIC CITY PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 MURPHY AVE STE 215
NASHVILLE TN
37203-1803
US

IV. Provider business mailing address

2201 MURPHY AVE STE 215
NASHVILLE TN
37203-1803
US

V. Phone/Fax

Practice location:
  • Phone: 615-712-8073
  • Fax: 615-915-4190
Mailing address:
  • Phone: 615-712-8073
  • Fax: 615-915-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YERUSALEM LANIER
Title or Position: OWNER
Credential:
Phone: 615-712-8073