Provider Demographics
NPI:1235163528
Name:DINKINS, EDWARD JEFF (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JEFF
Last Name:DINKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:DINKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5653 FRIST BLVD
Mailing Address - Street 2:SUITE 630
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2062
Mailing Address - Country:US
Mailing Address - Phone:615-391-3971
Mailing Address - Fax:615-369-2032
Practice Address - Street 1:4230 HARDING PIKE STE 900
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4900
Practice Address - Country:US
Practice Address - Phone:615-964-5824
Practice Address - Fax:615-301-7048
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40522207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3816019Medicaid
TNI161156OtherHEALTH SPRING
TN4132096OtherBCBS
TNP5707573OtherFIRST HEALTH
TN1426139OtherCIGNA
TN4132096OtherTENNCARE
TN7893843OtherAETNA
TNP00355087OtherR/R MCR
TN38160192 SO. HILLSMedicare PIN
TN1426139OtherCIGNA
TN3816019Medicaid