Healthcare Provider Details

I. General information

NPI: 1407802275
Provider Name (Legal Business Name): FAMILY PODIATRY CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HARDING PIKE STE 202
NASHVILLE TN
37205-2098
US

IV. Provider business mailing address

4230 HARDING PIKE STE 202
NASHVILLE TN
37205-2098
US

V. Phone/Fax

Practice location:
  • Phone: 615-662-6676
  • Fax: 615-662-8371
Mailing address:
  • Phone: 615-662-6676
  • Fax: 615-662-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ORLY COHEN
Title or Position: VP
Credential:
Phone: 615-662-6676