Basic Information
| Provider Information | |||||||||
| NPI: | 1639201130 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAXWELL | ||||||||
| FirstName: | BRITT | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 GREAT CIRCLE ROAD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152226977 | ||||||||
| FaxNumber: | 6152225322 | ||||||||
| Practice Location | |||||||||
| Address1: | 4220 HARDING PIKE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152226977 | ||||||||
| FaxNumber: | 6152225322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2007 | ||||||||
| LastUpdateDate: | 10/23/2014 | ||||||||
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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 | 207R00000X | 43574 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 43574 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 4191339 | 01 | TN | BCBS | OTHER | P00636910 | 01 | RAILROAD MEDICARE | OTHER | 6010894 | 01 | TN | BLUE CROSS-BLUE SHIELD | OTHER | 7100050920 | 01 | KY | KENTUCKY MEDICAID | OTHER | 1506530 | 05 | TN | MEDICAID |