Healthcare Provider Details

I. General information

NPI: 1790811222
Provider Name (Legal Business Name): NASHVILLE GASTROENTEROLOGY AND HEPATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 WALLACE RD SUITE 103
NASHVILLE TN
37211-4893
US

IV. Provider business mailing address

330 WALLACE RD SUITE 103
NASHVILLE TN
37211-4893
US

V. Phone/Fax

Practice location:
  • Phone: 615-390-5053
  • Fax: 615-832-5713
Mailing address:
  • Phone: 615-390-5053
  • Fax: 615-832-5713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number StateTN

VIII. Authorized Official

Name: MS. FALEECIA TAYLOR
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 615-390-5053