Basic Information
| Provider Information | |||||||||
| NPI: | 1114914579 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARTHRITIS SPECIALISTS OF NASHVILLE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2410 PATTERSON ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153404611 | ||||||||
| FaxNumber: | 6153404658 | ||||||||
| Practice Location | |||||||||
| Address1: | 2410 PATTERSON ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153404611 | ||||||||
| FaxNumber: | 6153404658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2005 | ||||||||
| LastUpdateDate: | 11/27/2012 | ||||||||
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| AuthorizedOfficialLastName: | LOCKE | ||||||||
| AuthorizedOfficialFirstName: | CHUCK | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6153737604 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RR0500X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 3712041 | 05 | TN | MEDICAID |