Basic Information
| Provider Information | |||||||||
| NPI: | 1215976527 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALENDINE | ||||||||
| FirstName: | CHAD | ||||||||
| MiddleName: | LOGAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3024 BUSINESS PARK CIR | ||||||||
| Address2: | |||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370723132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158516033 | ||||||||
| FaxNumber: | 6158512018 | ||||||||
| Practice Location | |||||||||
| Address1: | 3024 BUSINESS PARK CIR | ||||||||
| Address2: | |||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370723132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158516033 | ||||||||
| FaxNumber: | 6158512018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 08/08/2017 | ||||||||
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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 | 2085R0202X | MD38479 | TN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 4200985 | 01 | TN | BCBS TN | OTHER | 1509255 | 05 | TN | MEDICAID | PENDING | 01 | TN | CIGNA | OTHER | 3898456 | 05 | TN | MEDICAID | 4089411 | 01 | TN | BCBS | OTHER | P00226385 | 01 | TN | RAILROAD MEDICARE | OTHER | 1509255 | 01 | TN | MEDICAID - MTI | OTHER | 3898455 | 05 | TN | MEDICAID | 64094345 | 01 | KY | KY MEDICAID | OTHER | 6409434500 | 05 | KY | MEDICAID | 4089427 | 01 | TN | BCBS | OTHER | 4091783 | 01 | TN | BCBS | OTHER | 4291436 | 01 | TN | BCBS - MTI | OTHER |