1124613799 NPI number — URGENT SPECIALTY ASSOCIATES OF TENNESSEE PLLC

Table of content: (NPI 1124613799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124613799 NPI number — URGENT SPECIALTY ASSOCIATES OF TENNESSEE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URGENT SPECIALTY ASSOCIATES OF TENNESSEE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1124613799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 E LAMAR BLVD STE 430
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76006-7338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-229-5565
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 MEDICAL CENTER PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37129-2245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-790-5582
Provider Business Practice Location Address Fax Number:
239-790-5582
Provider Enumeration Date:
03/05/2021

Additional Information

Authorized Official

Authorized Official Last Name:
JOSEPHS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
469-766-8747

Provider Taxonomy Codes

  • Taxonomy code: 2086S0127X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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