Provider Demographics
NPI:1144776501
Name:KESTNERPHYSMED, LLC
Entity Type:Organization
Organization Name:KESTNERPHYSMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:KESTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-646-6700
Mailing Address - Street 1:7097 OLD HARDING PIKE
Mailing Address - Street 2:SUITE F
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2805
Mailing Address - Country:US
Mailing Address - Phone:615-646-6700
Mailing Address - Fax:
Practice Address - Street 1:7097 OLD HARDING PIKE
Practice Address - Street 2:SUITE F
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2805
Practice Address - Country:US
Practice Address - Phone:615-646-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty