MEDICARE: TREADWAY CLINIC

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	2084P0800X	Psychiatry Physician	MD6794	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	:	1730362468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREADWAY CLINIC

Provider Business Mailing Address
First Line	:	1516 16TH AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2906
Country	:	US
Telephone Number	:	615-383-7977
Fax Number	:	615-298-9606

Provider Business Practice Location Address
First Line	:	1516 16TH AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2906
Country	:	US
Telephone Number	:	615-383-7977
Fax Number	:	615-298-9606

Authorized Official
Title or Position	:	CHAIRMAN AND CEO
Name	:	DR. C. RICHARD FRANKLIN TREADWAY
Credential	:	M.D.
Telephone Number	:	615-383-7977

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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Directions to “TREADWAY CLINIC ” Practice Location

Language	Start Address	Practice Location

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