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Organization
TENNESSEE PHYSICIAN SERVICES, LLC
Active
Organization
TENNESSEE PHYSICIAN SERVICES, LLC
Active
Other names
United Telehealth Services
Organization subpart
No
Provider details
NPI number
Authorized official
DEB GOTT (DIRECTOR OF PROGRAM MANAGEMENT)
(800) 301-6254
Entity
Organization
Contact information
Practice address
1499 FAIR RD, STATESBORO, GA 30458-1683
(800) 301-6254
(888) 972-5992
Mailing address
5050 THOROUGHBRED LANE, SUITE C, BRENTWOOD, TN 37027
(800) 301-6254
(888) 972-5992
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181293A
—
GA
Enumeration date
05/08/2012
Last updated
02/14/2024
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