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General NPI Number Information
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NPI Number | 1912676461
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Entity Type | Organization
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Legal Business Name | MUSIC CITY PREP CLINIC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 225 S 11TH STREET STE 101A
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City | NASHVILLE
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State | TN
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Zip | 37206-3131
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Country | US
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Telephone | 615-469-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 225 S 11TH STREET STE 101A
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City | NASHVILLE
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State | TN
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Zip | 37206-3131
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Country | US
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Telephone | 615-469-1065
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OR CLINICAL OPERATIONS
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Name | JASON BUTLER
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Credential | FNP-BC, MHA
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Telephone | 615-469-1065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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