Provider Demographics
NPI:1447479282
Name:LIN, KUANG-TZU DAVIS (MD)
Entity type:Individual
Prefix:
First Name:KUANG-TZU
Middle Name:DAVIS
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 STEWARTS FERRY PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3325
Mailing Address - Country:US
Mailing Address - Phone:615-231-5000
Mailing Address - Fax:615-231-5145
Practice Address - Street 1:5504 COTTONPORT DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7640
Practice Address - Country:US
Practice Address - Phone:615-832-7046
Practice Address - Fax:615-832-7046
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3023435Medicare ID - Type Unspecified
TNA98737Medicare UPIN