Healthcare Provider Details

I. General information

NPI: 1639112048
Provider Name (Legal Business Name): PHILIP S KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 25TH AVE N STE 300B
NASHVILLE TN
37203-1632
US

IV. Provider business mailing address

250 25TH AVE N STE 300B
NASHVILLE TN
37203-1632
US

V. Phone/Fax

Practice location:
  • Phone: 615-340-2275
  • Fax: 615-340-2280
Mailing address:
  • Phone: 615-340-2275
  • Fax: 615-340-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number38823
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38823
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: