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AMG SOUTHERN TENNESSEE LLC

Physicians Otolaryngology

Provider NPI: 1568790632

Organization Information:
Organization Name:  AMG SOUTHERN TENNESSEE LLC
Organization is not Subpart
Authorized Official:  JESS N JUDY  PRESIDENT  615-372-8500

Practice Location:
1894 COWAN HWY SUITE 2 WINCHESTER, TN 37398-2624 US
Tel: 931-962-1020  Fax: 931-962-1043

Business Mailing Address:
1894 COWAN HWY SUITE 2 WINCHESTER, TN 37398-2624 US
Tel: 931-962-1020  Fax: 931-962-1043

NPI Information:
NPI: 1568790632
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Y00000XPhysicians
Otolaryngology

Other Provider Identifiers:

IssuerNumberStateType
1516481TN05



American Medical Association 2012 taxonomy code information

Code: 207Y00000X

Type:

Classification:



Definition:



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