Basic Information
| Provider Information | |||||||||
| NPI: | 1598743031 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NARAIN | ||||||||
| FirstName: | VIVEK | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 116800 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303689879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152616000 | ||||||||
| FaxNumber: | 6152616052 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 STEAM PLANT RD | ||||||||
| Address2: | UROLOGY ASSOCIATES, PC | ||||||||
| City: | GALLATIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154525225 | ||||||||
| FaxNumber: | 6152308907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2006 | ||||||||
| LastUpdateDate: | 09/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | MD36500 | TN | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 37450 | KY | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 36500 | TN | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 340020289 | 01 | TN | RR MEDICARE | OTHER | 4038906 | 01 | TN | BLUE CROSS | OTHER | 64054497 | 05 | KY | MEDICAID | 3876591 | 05 | TN | MEDICAID |