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Organization
CENTENNIAL SURGICAL CLINIC, LLC
Active
Organization
CENTENNIAL SURGICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VICE PRESIDENT)
(615) 373-7600
Entity
Organization
Contact information
Practice address
2400 PATTERSON ST STE 215, NASHVILLE, TN 37203-6501
(615) 342-7345
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7406
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/23/2010
Last updated
03/23/2023
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