Provider Demographics
NPI:1801923636
Name:NASHVILLE GASTROINTESTINAL SPECIALISTS, LLC
Entity type:Organization
Organization Name:NASHVILLE GASTROINTESTINAL SPECIALISTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CROMWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:1A BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: L&C
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6187
Mailing Address - Country:US
Mailing Address - Phone:615-665-1283
Mailing Address - Fax:615-234-1720
Practice Address - Street 1:2010 CHURCH STREET
Practice Address - Street 2:SUITE 420
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2012
Practice Address - Country:US
Practice Address - Phone:615-329-2141
Practice Address - Fax:615-321-1745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN490001202OtherRAILROAD MEDICARE PIN
TN3287213Medicare PIN