Basic Information
| Provider Information | |||||||||
| NPI: | 1649637133 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TENNESSEE TMS CENTER, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1720 W END AVE | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158611000 | ||||||||
| FaxNumber: | 6153201177 | ||||||||
| Practice Location | |||||||||
| Address1: | 1720 W END AVE | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158611000 | ||||||||
| FaxNumber: | 6153201177 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2016 | ||||||||
| LastUpdateDate: | 01/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | GAMMON | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 6158611000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 40598 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.