Provider Demographics
NPI:1043356959
Name:OLD HARDING PEDIATRIC ASSOCIATES
Entity type:Organization
Organization Name:OLD HARDING PEDIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUNKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-352-2995
Mailing Address - Street 1:5819 OLD HARDING RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3619
Mailing Address - Country:US
Mailing Address - Phone:615-352-2990
Mailing Address - Fax:615-352-9085
Practice Address - Street 1:5819 OLD HARDING RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-3619
Practice Address - Country:US
Practice Address - Phone:615-352-2990
Practice Address - Fax:615-352-9085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty