Provider Demographics
NPI:1760513212
Name:COOL SPRINGS ALLERGY ASSOCIATES PC
Entity Type:Organization
Organization Name:COOL SPRINGS ALLERGY ASSOCIATES PC
Other - Org Name:HAROLD F MOESSNER MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:BELLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-645-5689
Mailing Address - Street 1:251 HILLCREST DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5093
Mailing Address - Country:US
Mailing Address - Phone:931-645-5689
Mailing Address - Fax:931-645-2528
Practice Address - Street 1:251 HILLCREST DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5093
Practice Address - Country:US
Practice Address - Phone:931-645-5689
Practice Address - Fax:931-645-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000018213174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A99258Medicare UPIN
H92021Medicare UPIN
3885247Medicare ID - Type Unspecified
3720988Medicare ID - Type Unspecified