# AMG - SOUTHERN TENNESSEE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Tennessee Primary Care - Hunters Lane Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316480213
- **Authorized official:** JESS N. JUDY (PRESIDENT)
- **Authorized official phone:** (615) 920-7214

## Contact information

- **Practice address:** 100 HUNTERS LN, SUITE 100, TULLAHOMA, TN 37388-8263
- **Practice address phone:** (931) 455-4616
- **Practice address fax:** (931) 455-2362
- **Mailing address:** PO BOX 399, WINCHESTER, TN 37398-0399
- **Mailing address phone:** (931) 455-4616
- **Mailing address fax:** (931) 455-2362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/24/2016
- **Last updated:** 11/24/2016