# DR. VIJAY PETHKAR MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vijay Pethkar MD PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356474415
- **Authorized official:** VIJAY PETHKAR M.D. (OWNER)
- **Authorized official phone:** (615) 727-1963

## Contact information

- **Practice address:** 780 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3323
- **Practice address phone:** (615) 758-9273
- **Practice address fax:** (615) 758-4821
- **Mailing address:** 780 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3323
- **Mailing address phone:** (615) 758-9273
- **Mailing address fax:** (615) 758-4821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | MD31687 | TN | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | MD31687 | NULL | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | MD31687 | — | — |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | MD31687 | TN | — |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 02/05/2023