Organization
UT REGIONAL ONE PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH SITES III (EXECUTIVE DIRECTOR)
(901) 545-7125
Entity
Organization
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-8336
(901) 515-9486
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-8336
(901) 515-9486
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
02/20/2014
Last updated
03/29/2018
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