Basic Information
| Provider Information | |||||||||
| NPI: | 1124029699 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABBEY | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5653 FRIST BLVD STE 731 | ||||||||
| Address2: | |||||||||
| City: | HERMITAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370762066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158852778 | ||||||||
| FaxNumber: | 6159866052 | ||||||||
| Practice Location | |||||||||
| Address1: | 5653 FRIST BLVD STE 731 | ||||||||
| Address2: | |||||||||
| City: | HERMITAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370762066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158852778 | ||||||||
| FaxNumber: | 6159866052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2005 | ||||||||
| LastUpdateDate: | 10/22/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0106X | 21535 | TN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
ID Information
| ID | Type | State | Issuer | Description | 3062926 | 05 | TN | MEDICAID | 4209236 | 01 | TN | BCBS | OTHER |