Provider Demographics
NPI:1922766310
Name:BELLE MEADE ADDICTION MEDICINE & PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:BELLE MEADE ADDICTION MEDICINE & PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:STARNER
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:615-753-7966
Mailing Address - Street 1:4515 HARDING PIKE STE 326
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2118
Mailing Address - Country:US
Mailing Address - Phone:615-753-7966
Mailing Address - Fax:
Practice Address - Street 1:4515 HARDING PIKE STE 326
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2118
Practice Address - Country:US
Practice Address - Phone:615-753-7966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty