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Organization
UNIVERSITY OF TENNESSEE
Active
Organization
UNIVERSITY OF TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA L SULLIVAN (DIRECTOR)
(901) 448-2847
Entity
Organization
Contact information
Practice address
1301 PRIMACY PKWY, MEMPHIS, TN 38119-0213
(901) 448-0275
(901) 448-0404
Mailing address
16 BRENTSHIRE SQ, JACKSON, TN 38305-2203
(731) 664-0994
(731) 664-0866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TN
Other
Enumeration date
08/15/2005
Last updated
07/21/2022
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