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General NPI Number Information
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NPI Number | 1295818169
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Entity Type | Organization
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Legal Business Name | HERITAGE MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 222 22ND AVE N
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City | NASHVILLE
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State | TN
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Zip | 37203-1852
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Country | US
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Telephone | 629-255-3486
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Fax |
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Provider Business Mailing Address
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Address Line | 222 22ND AVE N
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City | NASHVILLE
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State | TN
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Zip | 37203-1852
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Country | US
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Telephone | 629-255-3486
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN SERVICES MANAGER
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Name | CRYSTIE R STAUSS
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Credential |
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Telephone | 629-255-2620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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