MEDICARE: DR. EDWARD JEFF DINKINS 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
1	207Q00000X	Family Medicine Physician	40522	TN
2	207R00000X	Internal Medicine Physician	40522	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
2	I161156	OTHER	TN	HEALTH SPRING
3	4132096	OTHER	TN	BCBS
4	P5707573	OTHER	TN	FIRST HEALTH
5	1426139	OTHER	TN	CIGNA
6	4132096	OTHER	TN	TENNCARE
7	7893843	OTHER	TN	AETNA
8	P00355087	OTHER	TN	R/R MCR

General Provider Information

NPI Number	:	1235163528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD JEFF DINKINS MD

Provider Business Mailing Address
First Line	:	5653 FRIST BLVD
Second Line	:	SUITE 630
City	:	HERMITAGE
State	:	TN
Zip	:	37076-2062
Country	:	US
Telephone Number	:	615-391-3971
Fax Number	:	615-369-2032

Provider Business Practice Location Address
First Line	:	4230 HARDING PIKE STE 900
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-4900
Country	:	US
Telephone Number	:	615-964-5824
Fax Number	:	615-301-7048

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	02/04/2022

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