Healthcare Provider Details

I. General information

NPI: 1952365355
Provider Name (Legal Business Name): THOMAS WERNER HOLZEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 WALLACE RD SUITE 202
NASHVILLE TN
37211-4880
US

IV. Provider business mailing address

393 WALLACE RD SUITE 202
NASHVILLE TN
37211-4880
US

V. Phone/Fax

Practice location:
  • Phone: 615-832-2200
  • Fax: 615-832-2020
Mailing address:
  • Phone: 615-832-2200
  • Fax: 615-832-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMD0000011936
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: