Organization
AXIAL CLINIC IN PC
Active
Organization
AXIAL CLINIC IN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE HEYWOOD (SECRETARY)
(615) 231-8560
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY STE 2313, LOUISVILLE, KY 40217-1444
(502) 406-8133
Mailing address
209 10TH AVE S STE 350, NASHVILLE, TN 37203-4166
(615) 231-8560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/15/2021
Last updated
06/11/2026
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