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Organization

ULTRA HEALTH PROVIDERS II LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES RICHARD JERMAN III (MEMBER)
(731) 234-8120
Entity
Organization

Contact information

Practice address
4128 OLD JACKSON RD, BELLS, TN 38006-4261
(731) 394-1145
Mailing address
PO BOX 26485, DEPT 1138, OKLAHOMA CITY, OK 73126
(731) 394-1145

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary

Other

Enumeration date
07/09/2024
Last updated
06/05/2025
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