Healthcare Provider Details

I. General information

NPI: 1528038676
Provider Name (Legal Business Name): DOUGLAS C MATHEWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 MURPHY AVE STE 301
NASHVILLE TN
37203-2023
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-9543
  • Fax: 615-341-3567
Mailing address:
  • Phone:
  • Fax: 615-341-3567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number29269
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: