Provider Demographics
NPI:1982863403
Name:COOL SPRINGS OBSTETRICS & GYNECOLOGY, P.C.
Entity Type:Organization
Organization Name:COOL SPRINGS OBSTETRICS & GYNECOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SANDS
Authorized Official - Last Name:LODGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-690-6600
Mailing Address - Street 1:1642 WESTGATE CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8194
Mailing Address - Country:US
Mailing Address - Phone:615-690-6600
Mailing Address - Fax:615-690-6605
Practice Address - Street 1:1804 WILLIAMSON CT
Practice Address - Street 2:SUITE 208
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8170
Practice Address - Country:US
Practice Address - Phone:615-690-6600
Practice Address - Fax:615-690-6605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD26575174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty