Organization
SWAN UROGYNECOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TABITHA MONDRAGE M.A. (OFFICE MANAGER)
(615) 515-9180
Entity
Organization
Contact information
Practice address
329 21ST AVENUE NORTH, SUITE 1, NASHVILLE, TN 37203-1857
(615) 515-9180
(615) 712-7647
Mailing address
329 21ST AVENUE NORTH, SUITE 1, NASHVILLE, TN 37203-1857
(615) 515-9180
(615) 712-7647
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104105873
MEDICARE
TN
05
—
1526073
—
TN
01
—
4296723
BCBS
TN
01
—
5347655
AETNA
TN
Enumeration date
08/11/2011
Last updated
07/21/2022
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