# UNIVERSITY HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UT Primary Care Jamestown
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669164307
- **Authorized official:** CAROL A BURGESS (PROVIDER ENROLLMENT TEAM LEAD)
- **Authorized official phone:** (865) 670-6754

## Contact information

- **Practice address:** 208 CENTRAL AVE W, JAMESTOWN, TN 38556-3557
- **Practice address phone:** (865) 670-6754
- **Mailing address:** PO BOX 415000-MSC8443, NASHVILLE, TN 37241-8443
- **Mailing address phone:** (865) 670-6199
- **Mailing address fax:** (865) 670-6198

## Taxonomy

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

## Other

- **Enumeration date:** 05/22/2023
- **Last updated:** 05/22/2023