# CENTENNIAL SURGICAL CLINIC, LLC

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

## Provider details

- **NPI number:** 1992009500
- **Authorized official:** LOUIS JOSEPH (VICE PRESIDENT)
- **Authorized official phone:** (615) 373-7600

## Contact information

- **Practice address:** 2400 PATTERSON ST STE 215, NASHVILLE, TN 37203-6501
- **Practice address phone:** (615) 342-7345
- **Mailing address:** 2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
- **Mailing address phone:** (615) 373-7406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |
| 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