Healthcare Provider Details

I. General information

NPI: 1952673253
Provider Name (Legal Business Name): NASHVILLE GENERAL RADIOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 ALBION ST
NASHVILLE TN
37208-2918
US

IV. Provider business mailing address

1818 ALBION ST
NASHVILLE TN
37208-2918
US

V. Phone/Fax

Practice location:
  • Phone: 615-341-4491
  • Fax: 615-341-4015
Mailing address:
  • Phone: 615-341-4491
  • Fax: 615-341-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON BOYD
Title or Position: CEO
Credential:
Phone: 615-341-4491