Provider Demographics
NPI:1497044093
Name:REDDICK, DARIAN EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIAN
Middle Name:EUGENE
Last Name:REDDICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-4029
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:5700 TEMPLE RD STE 301
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4223
Practice Address - Country:US
Practice Address - Phone:629-208-6160
Practice Address - Fax:628-280-6161
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3019412084N0008X, 2084N0400X
TN564212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA301941OtherLA LICENSE NUMBER