# AMG-SOUTHERN TENNESSEE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mountain Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669753042
- **Authorized official:** KATHY TEAGUE (AVP, SECRETARY)
- **Authorized official phone:** (615) 920-7000

## Contact information

- **Practice address:** 21 1ST STREET, MONTEAGLE, TN 37356
- **Practice address phone:** (931) 924-8000
- **Practice address fax:** (931) 924-8001
- **Mailing address:** 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
- **Mailing address phone:** (615) 920-7000
- **Mailing address fax:** (615) 920-8775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | — | NULL | Yes |
| 164W00000X | Licensed Practical Nurse | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2011
- **Last updated:** 10/11/2021