Provider Demographics
NPI:1336121821
Name:GOLD SKIN CARE CENTER
Entity Type:Organization
Organization Name:GOLD SKIN CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-383-2400
Mailing Address - Street 1:2000 RICHARD JONES RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2885
Mailing Address - Country:US
Mailing Address - Phone:615-383-2400
Mailing Address - Fax:615-383-1948
Practice Address - Street 1:2000 RICHARD JONES RD
Practice Address - Street 2:SUITE 220
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2885
Practice Address - Country:US
Practice Address - Phone:615-383-2400
Practice Address - Fax:615-383-1948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3705441Medicaid
TN3705441Medicare PIN
TNC44735Medicare UPIN