Provider Demographics
NPI:1588788301
Name:BANKS, SETH B (MD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:B
Last Name:BANKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1852
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:
Practice Address - Street 1:325 OLD PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4493
Practice Address - Country:US
Practice Address - Phone:629-255-2071
Practice Address - Fax:629-255-4163
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49067207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530190Medicaid
TN103I117068Medicare PIN
TN103I117068Medicare PIN
TNP01093448OtherRR MEDICARE
TN4333715OtherBCBS
TN621568119OtherUSA
TN10311I0849Medicare PIN
TN4333715OtherCIGNA
TN12647280OtherMULTIPLAN
TN621568119OtherBLUEGRASS
TN621568119OtherHUMANA
TN621568119OtherUNITED HEALTHCARE