# ST MARYS OBGYN LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. MARY'S HEALTH SYSTEM, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912963422
- **Legal business name:** ST. MARY'S HEALTH SYSTEM, INC
- **Authorized official:** MRS. DEBRA K LONDON (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (865) 545-7558

## Contact information

- **Practice address:** 120 HOSPITAL DR, SUITE 250, JEFFERSON CITY, TN 37760-5279
- **Practice address phone:** (865) 471-2644
- **Practice address fax:** (865) 471-2649
- **Mailing address:** 900 EAST OAK HILL AVENUE, KNOXVILLE, TN 37917-4556
- **Mailing address phone:** (865) 545-8000
- **Mailing address fax:** (865) 545-3105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/24/2006
- **Last updated:** 08/07/2009