Healthcare Provider Details
I. General information
NPI: 1497044093
Provider Name (Legal Business Name): DARIAN EUGENE REDDICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2011
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5700 TEMPLE RD STE 301
NASHVILLE TN
37221-4223
US
IV. Provider business mailing address
300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US
V. Phone/Fax
- Phone: 629-208-6160
- Fax: 628-280-6161
- Phone: 615-284-4029
- Fax: 615-284-7501
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0008X |
| Taxonomy | Neuromuscular Medicine (Psychiatry & Neurology) Physician |
| License Number | 301941 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 301941 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 56421 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: