| University Of Tennessee | |
|
1301 Primacy Pkwy Memphis TN 38119-0213 | |
| (901) 448-0275 | |
| (901) 448-0404 |
| Full Name | University Of Tennessee |
|---|---|
| Speciality | Family Medicine |
| Location | 1301 Primacy Pkwy, Memphis, Tennessee |
| Authorized Official Name and Position | Myra L Sullivan (DIRECTOR) |
| Authorized Official Contact | 9014482847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Tennessee 16 Brentshire Sq Jackson TN 38305-2203 Ph: (731) 664-0994 | University Of Tennessee 1301 Primacy Pkwy Memphis TN 38119-0213 Ph: (901) 448-0275 |
| NPI Number | 1780686170 |
|---|---|
| Provider Enumeration Date | 08/15/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780686170 | NPI | - | NPPES |
| 3713025 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Tennessee) | Primary |
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