Provider Demographics
NPI:1245224070
Name:KIRSHNER, NEIL EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:EDWARD
Last Name:KIRSHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 CENTRAL PIKE STE 251
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3421
Mailing Address - Country:US
Mailing Address - Phone:629-255-2028
Mailing Address - Fax:629-255-4219
Practice Address - Street 1:2025 N MOUNT JULIET RD STE 200
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3934
Practice Address - Country:US
Practice Address - Phone:629-255-2028
Practice Address - Fax:629-255-4219
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD23473208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ003402Medicaid
TN3497285Medicaid