Organization
PLATINUM MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD STEPHEN BOOMERSHINE M.D., PH.D. (MEDICAL DIRECTOR)
(615) 355-0554
Entity
Organization
Contact information
Practice address
515 STONECREST PKWY, SUITE 230, SMYRNA, TN 37167-6826
(615) 355-0554
(615) 435-3275
Mailing address
515 STONECREST PKWY, SUITE 230, SMYRNA, TN 37167-6826
(615) 355-0554
(615) 435-3275
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38402
TN
207RR0500X
Rheumatology Physician
38402
TN
208VP0000X
Pain Medicine Physician
Primary
38402
TN
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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