Basic Information
| Provider Information | |||||||||
| NPI: | 1982649257 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARGOLIES | ||||||||
| FirstName: | GARY | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 20TH AVE N | ||||||||
| Address2: | 9TH FLOOR | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152841400 | ||||||||
| FaxNumber: | 6152841693 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 20TH AVE N | ||||||||
| Address2: | 9TH FLOOR | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372032131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152841400 | ||||||||
| FaxNumber: | 6152841693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 02/06/2015 | ||||||||
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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 | 207RR0500X | 30405 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207R00000X | 30405 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | 21326 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 000000047065 | 01 | KY | BLUE CROSS & BLUE SHIELD | OTHER | 022092900 | 01 | KY | BLACK LUNG INSURANCE | OTHER | 1283881 | 01 | KY | UNITED MINE WORKERS ASSOC | OTHER | 4603211 | 01 | KY | AETNA INSURANCE COMPANY | OTHER | 110128892 | 01 | KY | RAILROAD MEDICARE | OTHER | 64304058 | 05 | KY | MEDICAID |