Healthcare Provider Details
I. General information
NPI: 1629951215
Provider Name (Legal Business Name): OHCJ WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US
IV. Provider business mailing address
4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US
V. Phone/Fax
- Phone: 844-386-3338
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
KING
Title or Position: PRESIDENT
Credential: DPM
Phone: 615-612-0122