Provider Demographics
NPI:1740511401
Name:CHAD T PRICE MD PC
Entity type:Organization
Organization Name:CHAD T PRICE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-444-4406
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37088-0725
Mailing Address - Country:US
Mailing Address - Phone:615-444-4406
Mailing Address - Fax:615-449-3174
Practice Address - Street 1:1616 W MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3100
Practice Address - Country:US
Practice Address - Phone:615-444-4406
Practice Address - Fax:615-449-3174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42715207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN615068301OtherUS DEPARTMENT OF LABOR
TN11777110OtherCAQH
TN6388600001Medicare NSC