MEDICARE: MUSIC CITY PHYSICIANS GROUP 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	261QH0100X	Health Service Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1740915719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSIC CITY PHYSICIANS GROUP PLLC

Provider Business Mailing Address
First Line	:	225 S 11TH ST STE 101B
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 S 11TH ST STE 101
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3131
Country	:	US
Telephone Number	:	615-469-1065
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MRS. YVONNE DAILEY
Credential	:
Telephone Number	:	732-244-2775

Provider Enumeration Date	:	07/22/2022
Last Update Date	:	01/11/2024

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