Provider Demographics
NPI:1992889471
Name:SON, KAY (MD)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:SON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:A
Other - Middle Name:KAY
Other - Last Name:SON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3413 NOLENSVILLE PIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2911
Mailing Address - Country:US
Mailing Address - Phone:615-333-8383
Mailing Address - Fax:615-333-1660
Practice Address - Street 1:3413 NOLENSVILLE PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2911
Practice Address - Country:US
Practice Address - Phone:615-333-8383
Practice Address - Fax:615-333-1660
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11290207R00000X
TN11290207RA0401X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3166197Medicare ID - Type Unspecified
TNB03158Medicare UPIN