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Individual

DR. GAUTAM JAYRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2801 CHARLOTTE AVE, NASHVILLE, TN 37209
(615) 250-9200
(615) 250-9251
Mailing address
PO BOX 409879, ATLANTA, GA 30384
(615) 261-6000
(615) 261-6052

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
125-051491
IL
208800000X
Urology Physician
Primary
51217
TN
208800000X
Urology Physician
D74312
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
55171600
MD
Enumeration date
06/11/2009
Last updated
08/07/2019
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