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Contact Information

LIFESTYLE MEDICAL GROUP, PLLC
4535 HARDING PIKE STE 210
NASHVILLE, TN37205-2120
 Phone: 615-269-6355
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internist

111NI0900X 35 Chiropractic
 

Chiropractor - Nutrition

111NN1001X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for LIFESTYLE MEDICAL GROUP, PLLC

NPI Number 1700062411
LBN Legal business name LIFESTYLE MEDICAL GROUP, PLLC
Authorized official ASA ANDREW - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/11/2008
Last updated 08/03/2009 - About 17 years ago
Identifiers
TN License # 1894
TN Other 4204756 BLUECROSS BLUESHIELD
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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