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General NPI Number Information
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NPI Number | 1598195539
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Entity Type | Organization
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Legal Business Name | MEDMD INTERVENTIONAL CARE PC
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 12/07/2018
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Provider Practice Location Address
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Address Line | 314 COOL SPRINGS BLVD STE 100
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City | FRANKLIN
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State | TN
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Zip | 37067-6420
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Country | US
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Telephone | 615-879-8935
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Fax |
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Provider Business Mailing Address
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Address Line | 314 COOL SPRINGS BLVD STE 100
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City | FRANKLIN
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State | TN
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Zip | 37067-6420
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Country | US
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Telephone | 615-879-8935
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Fax |
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Authorized Official
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Title or Position | CEO, PRESIDENT
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Name | DR. BENJAMIN JOHNSON
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Credential | MD
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Telephone | 615-879-8935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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