Provider Demographics
NPI:1235172800
Name:MEHTA, ARCHANA KOCHAR (MD)
Entity Type:Individual
Prefix:
First Name:ARCHANA
Middle Name:KOCHAR
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 MONARCH WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2621
Mailing Address - Country:US
Mailing Address - Phone:615-396-4694
Mailing Address - Fax:615-396-6751
Practice Address - Street 1:1247 MONARCH WAY
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2621
Practice Address - Country:US
Practice Address - Phone:615-396-4694
Practice Address - Fax:615-396-6751
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38054207R00000X
TN0000038054208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3893780Medicaid
TN3893784Medicaid
TN4153155OtherBLUECROSS
TNQ011983Medicaid
TN4119497OtherBLUECROSS
TNP00297034OtherRAILROAD MEDICARE
TN3893782Medicare PIN
TN4119497OtherBLUECROSS
TNP00297034OtherRAILROAD MEDICARE
TN4153155OtherBLUECROSS