Provider Demographics
NPI:1679576839
Name:HARTNESS, WILLIAM OWEN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:OWEN
Last Name:HARTNESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-329-5144
Mailing Address - Fax:615-284-2595
Practice Address - Street 1:222 22ND AVE N
Practice Address - Street 2:STE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1831
Practice Address - Country:US
Practice Address - Phone:615-329-5144
Practice Address - Fax:615-284-2595
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17016207RC0000X, 207RI0011X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00669756OtherRR MEDICARE
TN6012065OtherBLUE CROSS-BLUE SHIELD
TN3019665Medicaid
TN1506111Medicaid
TNP00669756OtherRR MEDICARE
TN3019667Medicare ID - Type Unspecified
TN3019665Medicaid