Provider Demographics
NPI:1366763591
Name:DRIMER KAGAN, TALY (MD)
Entity type:Individual
Prefix:DR
First Name:TALY
Middle Name:
Last Name:DRIMER KAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TALY
Other - Middle Name:
Other - Last Name:DRIMER-KAGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:304 NORTHCREEK BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2098
Mailing Address - Country:US
Mailing Address - Phone:615-859-9902
Mailing Address - Fax:615-859-9906
Practice Address - Street 1:304 NORTHCREEK BLVD STE 120
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2098
Practice Address - Country:US
Practice Address - Phone:615-859-9902
Practice Address - Fax:615-859-9906
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100383942084P0800X
NC2014-009192084P0800X
TXP72702084P0800X
TN531372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry