Provider Demographics
NPI:1144283896
Name:TEPPER, PATRICIA ANN (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:TEPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 25TH AVE N
Mailing Address - Street 2:SUITE 602
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1606
Mailing Address - Country:US
Mailing Address - Phone:615-312-0122
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N
Practice Address - Street 2:SUITE 602
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-312-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL165772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3822438OtherTSC
TN3822437OtherTNONC
KY64130073Medicaid
TN3791307OtherSMRI
TN1508967OtherIANP
TN3822436Medicaid
AL300025025OtherRAILROAD MEDICARE
TN3791068Medicaid
AL300025025OtherRAILROAD MEDICARE
TN3718587Medicaid
AL000084593Medicare ID - Type Unspecified
TN3822436Medicare ID - Type UnspecifiedRA GROUP
TN3791307Medicare ID - Type UnspecifiedSMRI GROUP