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Organization
UNIVERSITY OF TENNESSEE
Active
Organization
UNIVERSITY OF TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN L PORTER (MANAGER)
(731) 265-8220
Entity
Organization
Contact information
Practice address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 423-4919
Mailing address
294 SUMMAR DR, DEPT. 289, JACKSON, TN 38301-3915
(731) 265-8220
(731) 265-8355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TN
Other
Enumeration date
08/12/2005
Last updated
07/21/2022
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