Organization · NPI-2

Boston Medical Group Tennessee L.L.C.

Urology · Nashville, TN

NPI number1891193041
StatusActive
Last updated in NPPESDec 19, 2014

Details

NPI
1891193041
Entity type
Organization (NPI-2)
Legal business name
Boston Medical Group Tennessee L.L.C.
Organization subpart
No
Enumeration date
Dec 19, 2014
Last updated
Dec 19, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208800000X Urology4878TNYes

Practice location

1916 Patterson St
Suite 715
Nashville, TN 37203

Phone 615-562-4578 · Fax 423-949-3992

Mailing address

23275 S Pointe Drive
Suite 100
Laguna Hills, CA 92653

Phone 615-562-4578 · Fax 423-949-3992

Authorized official

Joan Simpson
Director Of Cqrm
6155624578

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