Provider Demographics
NPI:1871699546
Name:AFFILIATED INTERNISTS PC
Entity type:Organization
Organization Name:AFFILIATED INTERNISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:KIRK
Authorized Official - Last Name:PARDUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-871-0555
Mailing Address - Street 1:5653 FRIST BLVD
Mailing Address - Street 2:SUITE 236
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-871-0555
Mailing Address - Fax:615-871-9398
Practice Address - Street 1:5653 FRIST BLVD
Practice Address - Street 2:SUITE 236
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-871-0555
Practice Address - Fax:615-871-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD024626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65948Medicare UPIN
TN3712308Medicare ID - Type Unspecified