Individual
MR. BRETT L THORSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 851-2018
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 851-2018
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
25159
TN
2085R0202X
Diagnostic Radiology Physician
Primary
MD25159
TN
2085R0204X
Vascular & Interventional Radiology Physician
25159
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1509319
MEDICAID - MTI
TN
05
—
1509319
—
TN
01
—
1600684
UNITED HEALTHCARE OF TN
TN
01
—
2644117
CIGNA
TN
01
—
300106387
RAILROAD MEDICARE
TN
05
—
3080836
—
TN
01
—
3102002
BCBS
TN
01
—
3135871
BCBS
TN
01
—
4076947
BCBS
TN
01
—
4201075
BCBS TN
TN
01
—
4291298
BCBS - MTI
TN
01
—
64917941
KY MEDICAID
KY
05
—
64917941
—
KY
Enumeration date
05/24/2006
Last updated
12/02/2011
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