MEDICARE: DR. VIJAY PETHKAR MD PLLC

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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	MD31687
2	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	MD31687	TN
3	207RP1001X	Pulmonary Disease Physician	MD31687	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	:	1356474415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. VIJAY PETHKAR MD PLLC

Provider Business Mailing Address
First Line	:	780 N MOUNT JULIET RD
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-3323
Country	:	US
Telephone Number	:	615-758-9273
Fax Number	:	615-758-4821

Provider Business Practice Location Address
First Line	:	780 N MOUNT JULIET RD
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-3323
Country	:	US
Telephone Number	:	615-758-9273
Fax Number	:	615-758-4821

Authorized Official
Title or Position	:	OWNER
Name	:	VIJAY PETHKAR
Credential	:	M.D.
Telephone Number	:	615-727-1963

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	02/05/2023

Similar Medicare Providers

1336073899 — EVAN LOMAX
Practice Location Address:

684 N MOUNT JULIET RD
MOUNT JULIET, TN
37122-3323

Practice Phone: 615-758-6800
Practice Fax:

1497784631 — MT. JULIET FAMILY CARE AND WALK-IN CLINIC, LLC
Practice Location Address:

754 N MOUNT JULIET RD
MT JULIET, TN
37122-3323

Practice Phone: 615-754-2828
Practice Fax:

1225060999 — BRUCE E MCLAUGHLIN NP
Practice Location Address:

754 N MOUNT JULIET RD
MT JULIET, TN
37122-3323

Practice Phone: 615-754-2828
Practice Fax: 615-754-2818

1447282611 — JIMMY WAYNE CHEEKS JR. NP
Practice Location Address:

754 N MOUNT JULIET RD
MOUNT JULIET, TN
37122-3323

Practice Phone: 615-754-2828
Practice Fax: 651-754-2818

1447352372 — PROVIDENCE DENTAL CARE, INC.
Practice Location Address:

684 N MOUNT JULIET RD
MOUNT JULIET, TN
37122-3323

Practice Phone: 615-758-6800
Practice Fax: 615-758-8419

1659424968 — MRS. KIMBERLY ANN FAULKNER N.P.
Practice Location Address:

754 N MOUNT JULIET RD
MT JULIET, TN
37122-3323

Practice Phone: 615-754-2828
Practice Fax:

Directions to “DR. VIJAY PETHKAR MD PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.