# PLATINUM MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962824482
- **Authorized official:** DR. CHAD STEPHEN BOOMERSHINE M.D., PH.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (615) 355-0554

## Contact information

- **Practice address:** 515 STONECREST PKWY, SUITE 230, SMYRNA, TN 37167-6826
- **Practice address phone:** (615) 355-0554
- **Practice address fax:** (615) 435-3275
- **Mailing address:** 515 STONECREST PKWY, SUITE 230, SMYRNA, TN 37167-6826
- **Mailing address phone:** (615) 355-0554
- **Mailing address fax:** (615) 435-3275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 38402 | TN | — |
| 207RR0500X | Rheumatology Physician | 38402 | TN | — |
| 208VP0000X | Pain Medicine Physician | 38402 | TN | Yes |

## Other

- **Enumeration date:** 01/17/2014
- **Last updated:** 01/17/2014