Basic Information
Provider Information
NPI: 1962922674
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSSI
FirstName: DOUGLAS
MiddleName: ANTHONY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 PATTERSON ST STE 100
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032385
CountryCode: US
TelephoneNumber: 6153420038
FaxNumber:  
Practice Location
Address1: 2400 PATTERSON ST STE 100
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032385
CountryCode: US
TelephoneNumber: 6153420038
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/23/2017
LastUpdateDate: 07/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X4301112473MIN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000X64719TNY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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