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Contact Information

PONTCHARTRAIN MEDICAL GROUP, A PROFESSIONAL CORPORATION
200 POWELL PL
ATTN: LEGAL DEPARTMENT
BRENTWOOD, TN37027-7514
 Phone: 615-732-1605
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PONTCHARTRAIN MEDICAL GROUP, A PROFESSIONAL CORPORATION

NPI Number 1356704357
LBN Legal business name PONTCHARTRAIN MEDICAL GROUP, A PROFESSIONAL CORPORATION
Authorized official MARK CALARCO - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/29/2016
Last updated 08/25/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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