Provider Demographics
NPI:1295826535
Name:GOERTZ, STEVEN RICHARD (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RICHARD
Last Name:GOERTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 GREEN VW
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5005
Mailing Address - Country:US
Mailing Address - Phone:615-783-0958
Mailing Address - Fax:
Practice Address - Street 1:2107 EDWARD CURD LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5615
Practice Address - Country:US
Practice Address - Phone:615-591-9890
Practice Address - Fax:615-591-5899
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN356552085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E41123Medicare UPIN
TN3870654Medicare ID - Type Unspecified