Organization
NOL, LLC
Active
Other names
Premier Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN VAUGHN (AUTHORIZED OFFICIAL)
(629) 317-1465
Entity
Organization
Contact information
Practice address
812 N CHARLOTTE ST, DICKSON, TN 37055-1009
(615) 986-6411
(615) 986-6412
Mailing address
PO BOX 306512, NASHVILLE, TN 37230-6512
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0139565
BCBS
TN
05
—
3719420
—
TN
01
—
CG1374
RAILROAD MEDICARE
TN
Enumeration date
09/12/2006
Last updated
05/14/2026
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