Provider Demographics
NPI:1154309896
Name:FLEMING, PHILIP E (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:E
Last Name:FLEMING
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 1:2001 CHARLOTTE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2032
Mailing Address - Country:US
Mailing Address - Phone:615-377-7702
Mailing Address - Fax:615-377-7741
Practice Address - Street 1:2001 CHARLOTTE AVE STE 205
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2032
Practice Address - Country:US
Practice Address - Phone:615-377-7702
Practice Address - Fax:615-377-7741
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000014474174400000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6029206OtherBCBS
TNQ010852Medicaid
TN6029206OtherBCBS
TN103I247686Medicare PIN