Healthcare Provider Details

I. General information

NPI: 1588853634
Provider Name (Legal Business Name): HICKORY MEDICAL ADVISORS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5515 EDMONDSON PIKE STE 115
NASHVILLE TN
37211-5871
US

IV. Provider business mailing address

395 WALLACE RD STE 301B
NASHVILLE TN
37211-8023
US

V. Phone/Fax

Practice location:
  • Phone: 615-333-1490
  • Fax: 615-333-1522
Mailing address:
  • Phone: 615-333-1490
  • Fax: 615-333-1934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number30718
License Number StateTN

VIII. Authorized Official

Name: DR. ALADRAINE E SANDS
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 615-333-1490