Basic Information
Provider Information
NPI: 1427357532
EntityType: 2
ReplacementNPI:  
OrganizationName: ASCEND MEDICAL GROUP, LLC
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Mailing Information
Address1: 2001 CHARLOTTE AVE
Address2: SUITE 205
City: NASHVILLE
State: TN
PostalCode: 372032032
CountryCode: US
TelephoneNumber: 6157305304
FaxNumber: 6157305394
Practice Location
Address1: 2269 WILMA RUDOLPH BLVD
Address2:  
City: CLARKSVILLE
State: TN
PostalCode: 370403179
CountryCode: US
TelephoneNumber: 6154993292
FaxNumber: 6157305394
Other Information
ProviderEnumerationDate: 03/15/2011
LastUpdateDate: 03/15/2011
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AuthorizedOfficialLastName: KIMBROUGH
AuthorizedOfficialFirstName: TAMI
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AuthorizedOfficialTitleorPosition: OM
AuthorizedOfficialTelephone: 6154993292
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IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XAPN0000008034TNY193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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