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General NPI Number Information
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NPI Number | 1710207436
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Entity Type | Individual
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Provider Name | JACOB RICHARD RADFORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 3443 DICKERSON PIKE STE 310
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City | NASHVILLE
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State | TN
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Zip | 37207-2523
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Country | US
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Telephone | 615-645-3013
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Fax | 615-621-3158
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Provider Business Mailing Address
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Address Line | 3443 DICKERSON PIKE STE 310
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City | NASHVILLE
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State | TN
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Zip | 37207-2523
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Country | US
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Telephone | 615-645-3013
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Fax | 615-621-3158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R2347
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 49653
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 49653
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License Number State | TN
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