MEDICARE: NASHVILLE NOSE AND SINUS CENTER, 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	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1801418298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASHVILLE NOSE AND SINUS CENTER, PLLC

Provider Business Mailing Address
First Line	:	2019 SHORELINE DR
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-2274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	660 S MOUNT JULIET RD STE 120
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-3968
Country	:	US
Telephone Number	:	615-583-9823
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LUCAS BRYANT
Credential	:	MD
Telephone Number	:	615-855-7585

Provider Enumeration Date	:	05/08/2020
Last Update Date	:	05/22/2020

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