Provider Demographics
NPI:1174533772
Name:MEHTA, HEMAL V (MD)
Entity type:Individual
Prefix:
First Name:HEMAL
Middle Name:V
Last Name:MEHTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 LONGMOORE LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1436
Mailing Address - Country:US
Mailing Address - Phone:615-336-6715
Mailing Address - Fax:
Practice Address - Street 1:2042 LASCASSAS PIKE STE A4
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2034
Practice Address - Country:US
Practice Address - Phone:615-229-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN385172081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1511689Medicaid
TN1511689Medicaid
NC1174533772Medicaid
TN1511689Medicaid
NCNCK556D540Medicare PIN