Organization
MID-SOUTH MEDICAL PARTNERS LLC
Active
Organization
MID-SOUTH MEDICAL PARTNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH HOMOLYA MD (MANAGER)
(615) 419-2042
Entity
Organization
Contact information
Practice address
4230 HARDING PIKE STE 807, NASHVILLE, TN 37205-4900
(615) 419-2042
Mailing address
4230 HARDING PIKE STE 807, NASHVILLE, TN 37205-4900
(615) 419-2042
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
01/13/2020
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