Organization
BELLEVUE MEDICAL GROUP, LLC
Active
Organization
BELLEVUE MEDICAL GROUP, LLC
Active
Other names
West End Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P. HOUSER (PRESIDENT AND CEO)
(615) 284-6861
Entity
Organization
Contact information
Practice address
4230 HARDING RD, SUITE 530 HEART INSTITUTE, NASHVILLE, TN 37205-2013
(615) 297-6006
(615) 298-6778
Mailing address
PO BOX 504556, SAINT LOUIS, MO 63150-0001
(615) 297-6006
(615) 298-6778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3374489
—
TN
01
—
4028930
BLUE CROSS BLUE SHIELD
TN
01
—
DG9953
RAILROAD MEDICARE
TN
Enumeration date
06/28/2007
Last updated
05/15/2008
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