MEDICARE: RADIOLOGY & NUCLEAR MEDICINE ASSOCIATES

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	2085R0202X	Diagnostic Radiology Physician		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	:	1902876352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGY & NUCLEAR MEDICINE ASSOCIATES

Provider Business Mailing Address
First Line	:	200 SIGNATURE PLACE
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087
Country	:	US
Telephone Number	:	615-444-2320
Fax Number	:	615-449-3163

Provider Business Practice Location Address
First Line	:	1411 W BADDOUR PKWY
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-2513
Country	:	US
Telephone Number	:	615-444-2320
Fax Number	:	615-449-3163

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	DEBBIE DISMUKES
Credential	:
Telephone Number	:	615-444-2320

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/22/2020

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