Provider Demographics
NPI:1548357205
Name:MONACO, JOHN B (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:B
Last Name:MONACO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 WOODMONT BLVD STE LL50
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2382
Mailing Address - Country:US
Mailing Address - Phone:615-386-2361
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING PIKE STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4900
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-301-5010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT021661207VG0400X
TN50833207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100329280Medicaid
TN1534430Medicaid
TN6030555OtherBCBST
CT001216613Medicaid
KY7100329280Medicaid
CT160001587Medicare PIN
TN6030555OtherBCBST
CT001216613Medicaid