Provider Demographics
NPI:1649352980
Name:AMERICAN COSMETIC SURGERY CENTER, PC
Entity type:Organization
Organization Name:AMERICAN COSMETIC SURGERY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:KREEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-385-0660
Mailing Address - Street 1:2309 CRESTMOOR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2043
Mailing Address - Country:US
Mailing Address - Phone:615-385-0660
Mailing Address - Fax:615-386-3042
Practice Address - Street 1:2309 CRESTMOOR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2043
Practice Address - Country:US
Practice Address - Phone:615-385-0660
Practice Address - Fax:615-386-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16095208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3727065Medicare ID - Type UnspecifiedGROUP
TNA98747Medicare UPIN