Provider Demographics
NPI: | 1407851074 |
---|---|
Name: | BEST, TONY P (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | TONY |
Middle Name: | P |
Last Name: | BEST |
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: | 110 29TH AVE N |
Mailing Address - Street 2: | STE 202 |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37203-1448 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 110 29TH AVE N |
Practice Address - Street 2: | STE 202 |
Practice Address - City: | NASHVILLE |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37203-1448 |
Practice Address - Country: | US |
Practice Address - Phone: | 615-327-4304 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-06-20 |
Last Update Date: | 2015-11-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TN | 021465 | 174400000X |
TN | 21465 | 207L00000X |
KY | 24604 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | |
No | 174400000X | Other Service Providers | Specialist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AL | 009991765 | Medicaid | |
TN | 3029973 | Other | BCBS PROVIDER NUMBER |
TN | 3061237 | Medicaid | |
KY | 64911498 | Medicaid | |
TN | 3061238 | Medicare PIN | |
TN | 3061237 | Medicaid |