Basic Information
| Provider Information | |||||||||
| NPI: | 1174564314 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STUART | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3024 BUSINESS PARK CIR | ||||||||
| Address2: | |||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370723132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158516033 | ||||||||
| FaxNumber: | 6292086008 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 STEAM PLANT RD | ||||||||
| Address2: | STE 300 | ||||||||
| City: | GALLATIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152308070 | ||||||||
| FaxNumber: | 6154521774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 03/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E-3567 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 41313 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.