Provider Demographics
NPI:1629598453
Name:FEMALE PHYSICIANS OF TENNESSEE, P.C.
Entity Type:Organization
Organization Name:FEMALE PHYSICIANS OF TENNESSEE, P.C.
Other - Org Name:FEMALE UROLOGY OF NASHVILLE PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERELY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRADDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-690-0026
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-0119
Mailing Address - Country:US
Mailing Address - Phone:615-476-9018
Mailing Address - Fax:615-468-0322
Practice Address - Street 1:310 25TH AVE N STE 202
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1515
Practice Address - Country:US
Practice Address - Phone:317-690-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive SurgeryGroup - Single Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty