Basic Information
Provider Information
NPI: 1568546679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABOU-KHALIL
FirstName: BASSEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3601 THE VANDERBILT CLINIC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372322551
CountryCode: US
TelephoneNumber: 6159362000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 03/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X18635TNN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0600XMD18635TNN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
2084N0600X18635TNY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology

No ID Information.


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