Provider Demographics
NPI:1639112048
Name:KUO, PHILIP S (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:S
Last Name:KUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 25TH AVE N STE 300B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1632
Mailing Address - Country:US
Mailing Address - Phone:615-340-2275
Mailing Address - Fax:615-340-2280
Practice Address - Street 1:250 25TH AVE N STE 300B
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1632
Practice Address - Country:US
Practice Address - Phone:615-340-2275
Practice Address - Fax:615-340-2280
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38823208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00355846OtherRAILROAD MEDICARE
KY6411791400OtherKENTUCKY MEDICAID
TN4141507OtherBCBS
7951657OtherAETNA
TN3339636Medicaid
TN3339639Medicaid
TN6011194OtherBCBS
P00377981OtherRAILROAD MEDICARE
TN103I111061Medicare PIN
TN3339636Medicaid
TN4141507OtherBCBS
KY6411791400OtherKENTUCKY MEDICAID