Basic Information
Provider Information
NPI: 1033156310
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEFLIN
FirstName: ASA
MiddleName: CLYDE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 104 WOODMONT BLVD
Address2: SUITE LL50
City: NASHVILLE
State: TN
PostalCode: 372052245
CountryCode: US
TelephoneNumber: 6153862300
FaxNumber: 6153862399
Practice Location
Address1: 4230 HARDING RD
Address2: SUITE 400
City: NASHVILLE
State: TN
PostalCode: 372052013
CountryCode: US
TelephoneNumber: 6152972700
FaxNumber: 6152694584
Other Information
ProviderEnumerationDate: 06/02/2006
LastUpdateDate: 08/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X11149TNN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X11149TNY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001X17683KYN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
10470001TNUNITED HEALTH CAREOTHER
6477172805KY MEDICAID
150775705TN MEDICAID
406674901TNAETNAOTHER
1254139201TNMULTIPLAN/PHCSOTHER
29001353801TNMEDICARE RROTHER
849444401TNUSO/MCOOTHER
0106184501TNAMERIGROUPOTHER
252015401TNCIGNAOTHER
316431701TNBLUE CROSS OF TNOTHER


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