# ETMC PHYSICIAN GROUP INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UT Health East Texas Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720578941
- **Authorized official:** STEPHEN C. PETROVICH (EVP)
- **Authorized official phone:** (615) 296-3000

## Contact information

- **Practice address:** 1000 E 5TH ST STE 400, TYLER, TX 75701-3362
- **Practice address phone:** (903) 593-1749
- **Mailing address:** 1 BURTON HILLS BLVD STE 250, NASHVILLE, TN 37215-6195
- **Mailing address phone:** (615) 296-3000
- **Mailing address fax:** (615) 296-6227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2018
- **Last updated:** 05/14/2018