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General NPI Number Information
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NPI Number | 1952625808
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Entity Type | Organization
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Legal Business Name | MY WELL CARE
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Dates
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Enumeration Date | 03/22/2010
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 2275 MURFREESBORO PIKE STE 109 & 110
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City | NASHVILLE
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State | TN
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Zip | 37217-3341
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Country | US
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Telephone | 615-833-6898
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Fax | 615-833-6895
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Provider Business Mailing Address
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Address Line | PO BOX 58793
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City | NASHVILLE
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State | TN
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Zip | 37205-8793
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Country | US
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Telephone | 615-833-6898
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Fax | 615-833-6895
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CLARISSA NELSON ARTHUR
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Credential | MD
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Telephone | 615-833-6898
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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 | NULL
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