| Tn Wound Physician Llc | |
|
118 16th Ave S Ste 4-277 Nashville TN 37203-3100 | |
| (480) 389-6863 | |
| Not Available |
| Full Name | Tn Wound Physician Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 118 16th Ave S Ste 4-277, Nashville, Tennessee |
| Authorized Official Name and Position | Jarvis Tzeng (PRESIDENT) |
| Authorized Official Contact | 4803896863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tn Wound Physician Llc 118 16th Ave S Ste 4-277 Nashville TN 37203-3100 Ph: (480) 389-6863 | Tn Wound Physician Llc 118 16th Ave S Ste 4-277 Nashville TN 37203-3100 Ph: (480) 389-6863 |
| NPI Number | 1861103632 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 12/12/2022 |
| Medicare PECOS PAC ID | 8921464553 |
|---|---|
| Medicare Enrollment ID | O20230523003468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861103632 | NPI | - | NPPES |
| 1811137722 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jarvis A Tzeng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811137722 PECOS PAC ID: 4587858956 Enrollment ID: I20230818001844 |
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