Basic Information
| Provider Information | |||||||||
| NPI: | 1659302479 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NASHVILLE GASTROINTESTINAL SPECIALISTS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2010 CHURCH STREET | ||||||||
| Address2: | SUITE 312 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153292141 | ||||||||
| FaxNumber: | 6153011745 | ||||||||
| Practice Location | |||||||||
| Address1: | 2010 CHURCH STREET | ||||||||
| Address2: | SUITE 312 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153292141 | ||||||||
| FaxNumber: | 6153011745 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 11/14/2007 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | ALLAN | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6153292141 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NASHVILLE GASTROINTESTINAL SPECIALISTS INC | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | CA5850 | 01 | TN | RAILROAD MEDICARE PIN | OTHER |