Basic Information
Provider Information
NPI: 1306053939
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARRICO
FirstName: BRIAN
MiddleName: CHRISTOPHER
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 GREAT CIRCLE RD
Address2: SUITE 200
City: NASHVILLE
State: TN
PostalCode: 372281317
CountryCode: US
TelephoneNumber: 6152844672
FaxNumber: 6152845752
Practice Location
Address1: 2000 CHURCH ST
Address2: IP HOSPITALIST
City: NASHVILLE
State: TN
PostalCode: 372364400
CountryCode: US
TelephoneNumber: 6152844672
FaxNumber: 6152845752
Other Information
ProviderEnumerationDate: 05/16/2007
LastUpdateDate: 07/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X45557TNN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X45557TNY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
P0093680001TNRR MEDICAREOTHER
152360705TN MEDICAID
429924401TNBLUE CROSS/BLUE SHIELDOTHER


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