Healthcare Provider Details

I. General information

NPI: 1679063325
Provider Name (Legal Business Name): THOMAS MILLER MANIER BEAZLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 DICKERSON PIKE STE 600
NASHVILLE TN
37207-2525
US

IV. Provider business mailing address

3443 DICKERSON PIKE STE 600
NASHVILLE TN
37207-2525
US

V. Phone/Fax

Practice location:
  • Phone: 615-865-0700
  • Fax:
Mailing address:
  • Phone: 615-865-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number75085
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: