Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD0000009149 | TN |
NPI | 1053492884 |
---|---|
Provider Name | Dr. Arthur R. Cushman |
First Address | Goodlettsville, TN 37072 |
Second Address | Goodlettsville, TN 37072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 20/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201405662 | TAX ID (01) | TN |
300022493 | (05) | TN |
362778 | CIGNA (01) | TN |
4089533 | BLUE CROSS BLUE SHIELD (01) | TN |
B02697 | (02) | TN |