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General NPI Number Information
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NPI Number | 1437262854
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Entity Type | Organization
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Legal Business Name | RADNOR PSYCHIATRIC GROUP
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 5123 VIRGINIA WAY SUITE C-11
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City | BRENTWOOD
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State | TN
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Zip | 37027-7519
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Country | US
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Telephone | 615-373-5205
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Fax | 615-373-5165
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Provider Business Mailing Address
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Address Line | 5123 VIRGINIA WAY SUITE C-11
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City | BRENTWOOD
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State | TN
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Zip | 37027-7519
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Country | US
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Telephone | 615-373-5205
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Fax | 615-373-5165
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD EARLE ROCHESTER
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Credential | MD
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Telephone | 615-373-5205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18782
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License Number State | TN
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