Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD39402 | TN |
N | 207PE0004X | Emergency Medical Services | MD39402 | TN |
N | 207PP0204X | Pediatric Emergency Physician | 39402 | TN |
N | 207R00000X | Internist | 39402 | TN |
N | 111NI0900X | Internist | 39402 | TN |
NPI | 1235202003 |
---|---|
Provider Name | Andrew C Neck |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33286371 | (05) | TN |
4174929 | BCBS (01) | TN |
7100030680 | KENTUCKY MEDICAID (01) | KY |
7196872 | AETNA (01) | |
BN9103829 | DEA (01) | TN |