Healthcare Provider Details

I. General information

NPI: 1972128221
Provider Name (Legal Business Name): JOHN FINCHER GIST BOBO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 STONECREST BLVD STE 110
SMYRNA TN
37167-5689
US

IV. Provider business mailing address

300 STONECREST BLVD STE 110
SMYRNA TN
37167-5689
US

V. Phone/Fax

Practice location:
  • Phone: 615-223-6608
  • Fax: 615-223-6629
Mailing address:
  • Phone: 615-223-6608
  • Fax: 615-223-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number247018
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: