# TENNESSEE PHS PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDER HEALTH SERVICES LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184854473
- **Legal business name:** PROVIDER HEALTH SERVICES LLC
- **Authorized official:** NICOLE HOWARD (CFO)
- **Authorized official phone:** (337) 991-9276

## Contact information

- **Practice address:** 9155 CRESTWYN HILLS DR, MEMPHIS, TN 38125-8501
- **Practice address phone:** (901) 261-4858
- **Practice address fax:** (901) 261-4867
- **Mailing address:** 1509 DULLES DRIVE, LAFAYETTE, LA 70506
- **Mailing address phone:** (337) 991-9276
- **Mailing address fax:** (337) 991-9288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2009
- **Last updated:** 07/02/2014