Provider Demographics
NPI:1043294747
Name:NORDQUIST, FRED A (MD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:A
Last Name:NORDQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6294 HIGHWAY 41A
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-8175
Mailing Address - Country:US
Mailing Address - Phone:615-746-8872
Mailing Address - Fax:615-746-8871
Practice Address - Street 1:6294 HIGHWAY 41A
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-8175
Practice Address - Country:US
Practice Address - Phone:615-746-8872
Practice Address - Fax:615-746-8871
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN38308207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I27399Medicare UPIN