Healthcare Provider Details

I. General information

NPI: 1114223211
Provider Name (Legal Business Name): JAHRUL ISLAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13181 OLD NASHVILLE HWY STE 150
SMYRNA TN
37167-4034
US

IV. Provider business mailing address

13181 OLD NASHVILLE HWY STE 150
SMYRNA TN
37167-4034
US

V. Phone/Fax

Practice location:
  • Phone: 615-355-5105
  • Fax: 615-355-5195
Mailing address:
  • Phone: 615-355-5105
  • Fax: 615-355-5195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number67439
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number67439
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: