MEDICARE: MR. JAMES ROSS HEAD M.D

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
1	207Q00000X	Family Medicine Physician	MD12609	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1033180773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES ROSS HEAD M.D

Provider Business Mailing Address
First Line	:	1020 TULLOSS ROAD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067
Country	:	US
Telephone Number	:	615-202-5096
Fax Number	:	615-834-3008

Provider Business Practice Location Address
First Line	:	394 HARDING PL
Second Line	:	SUITE 102
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3980
Country	:	US
Telephone Number	:	615-834-3123
Fax Number	:	615-834-3008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	12/12/2016

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