Provider Demographics
NPI:1306872981
Name:BHATT, VIVAK S (MD)
Entity type:Individual
Prefix:DR
First Name:VIVAK
Middle Name:S
Last Name:BHATT
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 1:919 MURFREESBORO RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3002
Mailing Address - Country:US
Mailing Address - Phone:615-791-7264
Mailing Address - Fax:
Practice Address - Street 1:919 MURFREESBORO RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3002
Practice Address - Country:US
Practice Address - Phone:615-791-7264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36631207QA0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1512236Medicaid
TN4064697Medicaid
TN3878602Medicare ID - Type UnspecifiedMEDICARE NUMBER
TN1512236Medicaid