Provider Demographics
NPI:1205034014
Name:FRIST CLINIC EXPRESS LLC
Entity Type:Organization
Organization Name:FRIST CLINIC EXPRESS LLC
Other - Org Name:FRIST CLINIC EXPRESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-7600
Mailing Address - Street 1:2501 PARK PLZ
Mailing Address - Street 2:BUILDING ONE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1512
Mailing Address - Country:US
Mailing Address - Phone:615-344-2500
Mailing Address - Fax:615-344-2410
Practice Address - Street 1:2501 PARK PLZ
Practice Address - Street 2:BUILDING ONE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1512
Practice Address - Country:US
Practice Address - Phone:615-344-2500
Practice Address - Fax:615-344-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370193Medicare PIN