Provider Demographics
NPI:1588853634
Name:HICKORY MEDICAL ADVISORS, PC
Entity Type:Organization
Organization Name:HICKORY MEDICAL ADVISORS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALADRAINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-333-1490
Mailing Address - Street 1:395 WALLACE RD STE 301B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8023
Mailing Address - Country:US
Mailing Address - Phone:615-333-1490
Mailing Address - Fax:615-333-1934
Practice Address - Street 1:5515 EDMONDSON PIKE
Practice Address - Street 2:STE 115
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5871
Practice Address - Country:US
Practice Address - Phone:615-333-1490
Practice Address - Fax:615-333-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30718261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3830348Medicare PIN
TNF31665Medicare UPIN