Organization
THE HEART TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA WYNNE (OFFICE MANAGER)
(615) 329-1122
Entity
Organization
Contact information
Practice address
2400 PATTERSON ST, STE 223, NASHVILLE, TN 37203
(615) 329-1122
(615) 329-9211
Mailing address
2400 PATTERSON ST, STE 223, NASHVILLE, TN 37203
(615) 329-1122
(615) 329-9211
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10017047
AMERIGROUP COMMUNITY CARE
TN
01
—
1444239
BCBS
TN
05
—
3370612
—
TN
01
—
DA0874
RAILROAD MEDICARE
TN
Enumeration date
01/26/2006
Last updated
02/29/2008
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