MEDICARE: DR. JULIAN T HERTZ M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207P00000X	Emergency Medicine Physician	MD0000052316	TN

General Provider Information

NPI Number	:	1891138921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIAN T HERTZ M.D.

Provider Business Mailing Address
First Line	:	2146 BELCOURT AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-3504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 21ST AVE S
Second Line	:	703 OXFORD HOUSE
City	:	NASHVILLE
State	:	TN
Zip	:	37232-4700
Country	:	US
Telephone Number	:	614-936-1160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	03/21/2016

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