Basic Information
Provider Information
NPI: 1558724971
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STANDLEY
FirstName: STEVEN
MiddleName: MATTHEW
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 20TH AVE N STE 403
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372035180
CountryCode: US
TelephoneNumber: 6152847224
FaxNumber:  
Practice Location
Address1: 1700 MEDICAL CENTER PKWY
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371292245
CountryCode: US
TelephoneNumber: 6153964694
FaxNumber: 6153966751
Other Information
ProviderEnumerationDate: 04/02/2016
LastUpdateDate: 07/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X FLN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X59305TNY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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