Provider Demographics
NPI:1154461135
Name:HIXSON UROLOGY, PC
Entity Type:Organization
Organization Name:HIXSON UROLOGY, PC
Other - Org Name:THOMAS C CALDWELL, MD, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-877-2844
Mailing Address - Street 1:2051 HAMILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4093
Mailing Address - Country:US
Mailing Address - Phone:423-877-2844
Mailing Address - Fax:423-877-1959
Practice Address - Street 1:2051 HAMILL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4093
Practice Address - Country:US
Practice Address - Phone:423-877-2844
Practice Address - Fax:423-877-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3289003Medicaid
TN4160077OtherBLUE CROSS GROUP ID
TN3289003Medicaid
TN3289003Medicare PIN
3289003Medicare PIN