Provider Demographics
NPI:1619929247
Name:EMERGENCY MEDICINE CONSULTANTS OF NASHVILLE, INC
Entity Type:Organization
Organization Name:EMERGENCY MEDICINE CONSULTANTS OF NASHVILLE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:DAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-222-6733
Mailing Address - Street 1:PO BOX 3490
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-3490
Mailing Address - Country:US
Mailing Address - Phone:931-647-5034
Mailing Address - Fax:931-552-6663
Practice Address - Street 1:4220 HARDING RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-222-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3701032Medicaid
TN3039089OtherBCBS PROVIDER NUMBER
CN0831OtherRAILROAD MEDICARE GROUP
TN3039089OtherBCBS PROVIDER NUMBER