Provider Demographics
NPI:1952505414
Name:HENDERSONVILLE OBSTETRICS AND GYNECOLOGY
Entity Type:Organization
Organization Name:HENDERSONVILLE OBSTETRICS AND GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:PUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-822-3880
Mailing Address - Street 1:353 NEW SHACKLE ISLAND RD
Mailing Address - Street 2:SUITE 221 B
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2379
Mailing Address - Country:US
Mailing Address - Phone:615-822-3880
Mailing Address - Fax:615-264-1664
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD
Practice Address - Street 2:SUITE 221 B
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2379
Practice Address - Country:US
Practice Address - Phone:615-822-3880
Practice Address - Fax:615-264-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008768207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1033103551OtherDR. STEIER'S NPI #
TN1336134428OtherNPI - DR. RON RICE
TN3162290Medicare ID - Type UnspecifiedDR. RON RICE
TN1336134428OtherNPI - DR. RON RICE
TN3378843Medicare ID - Type UnspecifiedGROUP NUMBER
TN1033103551OtherDR. STEIER'S NPI #
TN3054380Medicare ID - Type UnspecifiedDR. JILL STEIER