Healthcare Provider Details

I. General information

NPI: 1538139811
Provider Name (Legal Business Name): SAINT THOMAS OUTPATIENT NEUROSURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HARDING RD SUITE 901
NASHVILLE TN
37205-2013
US

IV. Provider business mailing address

2011 MURPHY AVE STE 301
NASHVILLE TN
37203
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-9543
  • Fax:
Mailing address:
  • Phone: 615-327-9543
  • Fax: 615-341-7583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0000000128
License Number StateTN

VIII. Authorized Official

Name: SCOTT BUTLER
Title or Position: CFO
Credential:
Phone: 615-327-9543