=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134114630
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY G WEEKS MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2005
-----------------------------------------------------
Last Update Date | 03/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | THE VANDERBILT CLINIC R1200 MCN, 1161 21ST AVE SO
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37232-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-322-4563
-----------------------------------------------------
Fax | 615-936-2138
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3841 GREEN HILLS VILLAGE DR STE 200
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37215-2691
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-343-5700
-----------------------------------------------------
Fax | 615-936-2138
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 17899
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------