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NPI Code Detail

MEDICARE: DR. JOHN J NISBET MD

MEDICARE: DR. JOHN J NISBET MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianK2364TX
22085R0202XDiagnostic Radiology Physician58000TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033109285
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN J NISBET MD
Provider Business Mailing Address
First Line : 3024 BUSINESS PARK CIR
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-3132
Country : US
Telephone Number : 615-851-6033
Fax Number : 615-851-2018
Provider Business Practice Location Address
First Line : 3024 BUSINESS PARK CIR
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-3132
Country : US
Telephone Number : 615-851-6033
Fax Number : 615-234-1502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 03/27/2019

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