Healthcare Provider Details

I. General information

NPI: 1912100397
Provider Name (Legal Business Name): NASHVILLE FAMILY FOOT CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 11/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PATTERSON ST SUITE 123
NASHVILLE TN
37203-1562
US

IV. Provider business mailing address

2400 PATTERSON ST SUITE 123
NASHVILLE TN
37203-1562
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-2200
  • Fax: 615-327-2842
Mailing address:
  • Phone: 615-327-2200
  • Fax: 615-327-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MARDON RANDALL DAY
Title or Position: OWNER
Credential: DPM
Phone: 615-327-2200