Basic Information
Provider Information
NPI: 1346578267
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAY
FirstName: STEPHEN
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 608 NORRIS AVE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372043708
CountryCode: US
TelephoneNumber: 6156951432
FaxNumber: 6156951483
Practice Location
Address1: 4230 HARDING PIKE
Address2: SUITE 1000
City: NASHVILLE
State: TN
PostalCode: 372052013
CountryCode: US
TelephoneNumber: 6153832693
FaxNumber: 6152971449
Other Information
ProviderEnumerationDate: 12/04/2009
LastUpdateDate: 01/13/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X4698TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
044663105TN MEDICAID


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