Provider Demographics
NPI:1083818108
Name:FAIRVIEW MEDICAL CENTER
Entity Type:Organization
Organization Name:FAIRVIEW MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YEKOLLA
Authorized Official - Middle Name:MADHUSUDANA
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-799-1927
Mailing Address - Street 1:7100 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062
Mailing Address - Country:US
Mailing Address - Phone:615-799-1927
Mailing Address - Fax:615-799-1928
Practice Address - Street 1:7100 ADAMS DR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062
Practice Address - Country:US
Practice Address - Phone:615-799-1927
Practice Address - Fax:615-799-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty