Provider Demographics
NPI:1538139811
Name:SAINT THOMAS OUTPATIENT NEUROSURGICAL CENTER
Entity Type:Organization
Organization Name:SAINT THOMAS OUTPATIENT NEUROSURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-327-9543
Mailing Address - Street 1:2011 MURPHY AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-327-9543
Mailing Address - Fax:615-341-7583
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 901
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-327-9543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000128261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3288533Medicare PIN