Provider Demographics
NPI:1578719845
Name:MUSIC VALLEY MEDICAL CENTER, PLLC
Entity Type:Organization
Organization Name:MUSIC VALLEY MEDICAL CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:615-777-9336
Mailing Address - Street 1:2416 MUSIC VALLEY DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-1011
Mailing Address - Country:US
Mailing Address - Phone:615-777-9336
Mailing Address - Fax:615-552-0152
Practice Address - Street 1:2416 MUSIC VALLEY DR
Practice Address - Street 2:SUITE 118
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-1011
Practice Address - Country:US
Practice Address - Phone:615-777-9336
Practice Address - Fax:615-552-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8392261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1144288747OtherNPI
TN1538116561OtherNPI
TN1740384320OtherNPI