Basic Information
| Provider Information | |||||||||
| NPI: | 1235202003 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NECK | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 GREEN HILLS VILLAGE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372152691 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | VANDERBILT UMC DEPT OF EMERGENCY MEDICINE | ||||||||
| Address2: | 1313 21ST AVE S, #703 OXFORD HOUSE | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159360087 | ||||||||
| FaxNumber: | 6159361316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | MD39402 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207PP0204X | 39402 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine | 207R00000X | 39402 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | MD39402 | TN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4174929 | 01 | TN | BCBS | OTHER | 7100030680 | 01 | KY | KENTUCKY MEDICAID | OTHER | BN9103829 | 01 | TN | DEA | OTHER | 33286371 | 05 | TN | MEDICAID | 7196872 | 01 | AETNA | OTHER |