Provider Demographics
NPI:1346535903
Name:BRENTWOOD OB GYN
Entity Type:Organization
Organization Name:BRENTWOOD OB GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-815-7646
Mailing Address - Street 1:2201 MURPHY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1835
Mailing Address - Country:US
Mailing Address - Phone:615-815-7646
Mailing Address - Fax:615-646-5920
Practice Address - Street 1:2201 MURPHY AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1835
Practice Address - Country:US
Practice Address - Phone:615-815-7646
Practice Address - Fax:615-646-5920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-12
Last Update Date:2011-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44841207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522598Medicaid