Provider Demographics
NPI:1255492948
Name:CHESTER, CAROLINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:CHESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:HUDSON
Other - Last Name:CHESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:2201 MURPHY AVE STE 403
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1885
Practice Address - Country:US
Practice Address - Phone:615-320-3773
Practice Address - Fax:615-320-9815
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23862TN2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ019273Medicaid
TN6057014OtherBLUE CROSS BLUE SHIELD
TN3376386Medicaid
TN6057014OtherBLUE CROSS BLUE SHIELD
TNF39025Medicare UPIN
TN3376386Medicare ID - Type Unspecified