Individual
PAUL M BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4220 HARDING RD, NASHVILLE, TN 37205-2005
(615) 222-2111
Mailing address
PO BOX 3490, CLARKSVILLE, TN 37043-3490
(931) 647-5034
(931) 552-6663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24481
TN
207P00000X
Emergency Medicine Physician
24481
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3043899
BCBS PROVIDER NUMBER
TN
05
—
3076150
—
TN
01
—
930005969
RAILROAD MEDICARE PROVIDE
TN
Enumeration date
05/18/2006
Last updated
12/21/2016
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