MEDICARE: DR. KELVIN ANTOINE BAGGETT M.D., M.P.H., M.B.A.

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	207R00000X	Internal Medicine Physician	41419	TN
2	207R00000X	Internal Medicine Physician		NC

General Provider Information

NPI Number	:	1144410879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELVIN ANTOINE BAGGETT M.D., M.P.H., M.B.A.

Provider Business Mailing Address
First Line	:	1 PARK PLZ
Second Line	:	BUILDING II - 4WEST
City	:	NASHVILLE
State	:	TN
Zip	:	37203-6527
Country	:	US
Telephone Number	:	615-344-5408
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 DR. D.B. TODD JR. BLVD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37208-3599
Country	:	US
Telephone Number	:	615-327-5520
Fax Number	:

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

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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