Organization
AMG-SOUTHERN TENNESSEE LLC
Active
Parent organization
AMG-SOUTHERN TENNESSEE LLC
Other names
Ian S. Taylor, MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMG-SOUTHERN TENNESSEE LLC
Authorized official
WILLIAM GRACEY (COO)
(615) 372-8500
Entity
Organization
Contact information
Practice address
10054 OLD TULLAHOMA RD, TULLAHOMA, TN 37388-6122
(931) 455-6688
(931) 455-0892
Mailing address
10054 OLD TULLAHOMA RD, TULLAHOMA, TN 37388-6122
(931) 455-6688
(931) 455-0892
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3716445
—
TN
Enumeration date
09/21/2006
Last updated
06/17/2008
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