MEDICARE: METRO CENTER HEALTH CARE GROUP PC

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	332900000X	Non-Pharmacy Dispensing Site	15942	TN
2	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4438809	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366484032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO CENTER HEALTH CARE GROUP PC

Provider Business Mailing Address
First Line	:	131 FRENCH LANDING DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1511
Country	:	US
Telephone Number	:	615-254-9981
Fax Number	:	615-254-9747

Provider Business Practice Location Address
First Line	:	131 FRENCH LANDING DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1511
Country	:	US
Telephone Number	:	615-254-9981
Fax Number	:	615-254-9747

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	MELVIN W LIGHTFORD
Credential	:	MD
Telephone Number	:	615-254-9981

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	10/04/2007

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Directions to “METRO CENTER HEALTH CARE GROUP PC ” Practice Location

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