Provider Demographics
NPI:1427132521
Name:JARQUIN-VALDIVIA, ADRIAN ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:ALBERTO
Last Name:JARQUIN-VALDIVIA
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 1:2400 PATTERSON ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1562
Mailing Address - Country:US
Mailing Address - Phone:615-342-6840
Mailing Address - Fax:615-342-6844
Practice Address - Street 1:2400 PATTERSON ST
Practice Address - Street 2:SUITE 320
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1562
Practice Address - Country:US
Practice Address - Phone:615-348-6840
Practice Address - Fax:615-342-6844
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36571207L00000X
TN395712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00795628OtherRR MEDICARE
TN4247890OtherBCBS-TN
TN1515968Medicaid
TN4247890OtherBCBS-TN
TN103I133302Medicare PIN