Provider Demographics
NPI:1326617671
Name:HEERY, SAMUEL HAGOOD (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:HAGOOD
Last Name:HEERY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2154A ROCK CITY ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-3937
Mailing Address - Country:US
Mailing Address - Phone:912-223-0241
Mailing Address - Fax:
Practice Address - Street 1:719 THOMPSON LN STE 20400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4600
Practice Address - Country:US
Practice Address - Phone:615-936-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program