Organization
TENNESSEE PHLEBOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN AMORUSO (SR VP REVENUE)
(847) 593-8460
Entity
Organization
Contact information
Practice address
9020 OVERLOOK BLVD STE 150, BRENTWOOD, TN 37027-2727
(615) 401-7162
(615) 401-7163
Mailing address
PO BOX 1602, NORTHBROOK, IL 60065-1602
(847) 593-8460
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
TN
2085R0204X
Vascular & Interventional Radiology Physician
—
TN
208600000X
Surgery Physician
—
TN
2086S0129X
Vascular Surgery Physician
—
TN
Other
Enumeration date
07/11/2006
Last updated
05/04/2023
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