Provider Demographics
NPI:1083059372
Name:ADVANCED MEDICAL OF COOL SPRINGS PLLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL OF COOL SPRINGS PLLC
Other - Org Name:ADVANCED MEDICAL OF NASHVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-735-4806
Mailing Address - Street 1:28 WHITE BRIDGE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1467
Mailing Address - Country:US
Mailing Address - Phone:615-224-7779
Mailing Address - Fax:
Practice Address - Street 1:28 WHITE BRIDGE RD STE 208
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1467
Practice Address - Country:US
Practice Address - Phone:615-224-7779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty