Provider Demographics
NPI:1801225412
Name:VCP2 NASHVILLE PC
Entity type:Organization
Organization Name:VCP2 NASHVILLE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLIBURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-329-0029
Mailing Address - Street 1:2001 CHARLOTTE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-329-0029
Mailing Address - Fax:706-854-2149
Practice Address - Street 1:2001 CHARLOTTE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-329-0029
Practice Address - Fax:706-854-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty