Healthcare Provider Details

I. General information

NPI: 1477858983
Provider Name (Legal Business Name): INTEGRATED MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 HARDING PIKE SUITE 210
NASHVILLE TN
37205-2120
US

IV. Provider business mailing address

4535 HARDING PIKE SUITE 210
NASHVILLE TN
37205-2120
US

V. Phone/Fax

Practice location:
  • Phone: 615-269-6355
  • Fax:
Mailing address:
  • Phone: 615-269-6355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0085
License Number StateTN

VIII. Authorized Official

Name: DR. JOE MORGAN
Title or Position: MEDICAL DIRECTOR
Credential: D.O.
Phone: 615-495-3507