Provider Demographics
NPI:1265440416
Name:TIERNEY, BRIAN P (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:P
Last Name:TIERNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:2004 HAYES STREET
Practice Address - Street 2:SUITE 315
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2647
Practice Address - Country:US
Practice Address - Phone:615-320-8585
Practice Address - Fax:615-320-8565
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37454208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730164Medicaid
TN3888969Medicaid
TN6060171OtherBCBS TN
TN103I246917Medicare PIN
TNH15503Medicare UPIN