Provider Demographics
NPI:1316977150
Name:BEAIRD-GAINES, LILLIAN NICOLE (MD)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:NICOLE
Last Name:BEAIRD-GAINES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:N
Other - Last Name:SAILORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 BENTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2303
Mailing Address - Country:US
Mailing Address - Phone:615-292-9770
Mailing Address - Fax:615-292-9706
Practice Address - Street 1:601 BENTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2303
Practice Address - Country:US
Practice Address - Phone:615-292-9770
Practice Address - Fax:615-292-9706
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN028820207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I064694OtherMEDICARE - INDIVIDUAL
TN3824953Medicaid
TNG76677Medicare UPIN
TN103I371588Medicare PIN