Individual
JOHN T BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
42553
TN
207L00000X
Anesthesiology Physician
4301054992
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0508278902
BCBS
MI
05
—
2989097-10
—
MI
05
—
3000254
—
TN
05
—
4114073-10
—
MI
01
—
4153878
BCBS OF TN
TN
05
—
7100012340
—
KY
05
—
9910831
—
AL
Enumeration date
07/26/2006
Last updated
08/05/2009
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