Organization
ICON PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE D HAMILTON M.D. (CEO)
(615) 497-4372
Entity
Organization
Contact information
Practice address
1900 CHURCH ST, SUITE 300, NASHVILLE, TN 37203-2234
(615) 647-8282
(615) 647-8283
Mailing address
1900 CHURCH ST, SUITE 300, NASHVILLE, TN 37203-2234
(615) 647-8282
(615) 647-8283
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
19089
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3034011
—
TN
Enumeration date
04/03/2014
Last updated
04/03/2014
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