Individual
DR. IAN CHARLES BACKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-5864
(615) 322-5000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 322-6842
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
71282
TN
207P00000X
Emergency Medicine Physician
ME122968
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN17723
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014964700
—
FL
05
—
Q034257
—
TN
Enumeration date
06/27/2012
Last updated
04/17/2025
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