| Smyrna Psychiatry Llc | |
|
713 President Pl Ste A Smyrna TN 37167-5652 | |
| (615) 790-7992 | |
| (615) 790-8688 |
| Full Name | Smyrna Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 713 President Pl Ste A, Smyrna, Tennessee |
| Authorized Official Name and Position | Lynn Harb (CREDENTIALING) |
| Authorized Official Contact | 6157907992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smyrna Psychiatry Llc 713 President Pl Ste A Smyrna TN 37167-5652 Ph: (615) 790-7992 | Smyrna Psychiatry Llc 713 President Pl Ste A Smyrna TN 37167-5652 Ph: (615) 790-7992 |
| NPI Number | 1669016952 |
|---|---|
| Provider Enumeration Date | 10/30/2019 |
| Last Update Date | 10/30/2019 |
| Medicare PECOS PAC ID | 3971937988 |
|---|---|
| Medicare Enrollment ID | O20191230000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669016952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Prasad V Kondapavuluru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265538581 PECOS PAC ID: 5991799306 Enrollment ID: I20040409000033 |
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