Healthcare Provider Details

I. General information

NPI: 1932729191
Provider Name (Legal Business Name): ENO EYO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 METROPLEX DR STE 200A
NASHVILLE TN
37211-3139
US

IV. Provider business mailing address

446 METROPLEX DR STE 200A
NASHVILLE TN
37211-3139
US

V. Phone/Fax

Practice location:
  • Phone: 615-205-3577
  • Fax: 615-970-6267
Mailing address:
  • Phone: 615-205-3577
  • Fax: 615-970-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57356
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number69095
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number57356
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number69095
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: