MEDICARE: JOHN MATTHEW DUCEY 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	53120	TN

General Provider Information

NPI Number	:	1346507423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MATTHEW DUCEY M.D.

Provider Business Mailing Address
First Line	:	397 WALLACE RD STE 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-8025
Country	:	US
Telephone Number	:	615-834-6166
Fax Number	:

Provider Business Practice Location Address
First Line	:	397 WALLACE RD STE 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-8025
Country	:	US
Telephone Number	:	615-834-6166
Fax Number	:

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

Provider Enumeration Date	:	04/13/2012
Last Update Date	:	07/20/2015

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