Provider Demographics
NPI:1215938923
Name:WARREN, FRANK DOUGLAS (PA)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:DOUGLAS
Last Name:WARREN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD.
Mailing Address - Street 2:STE. 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228
Mailing Address - Country:US
Mailing Address - Phone:615-565-6386
Mailing Address - Fax:615-222-7237
Practice Address - Street 1:1015 N. HIGHLAND
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:615-895-3233
Practice Address - Fax:615-895-4119
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN624363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4010759OtherBCBS PROVIDER #
TN3032985Medicare PIN
TN4010759OtherBCBS PROVIDER #