Healthcare Provider Details

I. General information

NPI: 1558003103
Provider Name (Legal Business Name): JOSHUA ADAM GELLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CHILDRENS WAY STE 1221
NASHVILLE TN
37212-3164
US

IV. Provider business mailing address

1031 HAGAN AVE
NEW ORLEANS LA
70119-3235
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-0738
  • Fax: 615-322-4586
Mailing address:
  • Phone: 913-231-5503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: