Organization
UT MEDICAL GROUP, INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD O. BAER (CHIEF OPERATING OFFICER)
(901) 866-8372
Entity
Organization
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-7366
Mailing address
1407 UNION AVE, SUITE 640, MEMPHIS, TN 38104-3627
(901) 866-8372
(901) 302-2360
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
15537
TN
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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