Provider Demographics
NPI:1821090051
Name:LEA, JOHN IV (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:LEA
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:95 WHITE BRIDGE RD
Mailing Address - Street 2:STE 250
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1497
Mailing Address - Country:US
Mailing Address - Phone:615-354-5930
Mailing Address - Fax:615-356-5220
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:STE 202
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-4781
Practice Address - Fax:615-356-5220
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD014202208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3740030OtherUNITED HEALTHCARE
TN60055OtherBCBS OF TENNESSEE
TN1508941004OtherCIGNA PPO
TN1508941005OtherCIGNA HMO
TN4066875OtherAETNA PPO
TN0995592OtherAETNA HMO
TN3009252Medicaid
TN1508941005OtherCIGNA HMO