Organization
TENNESSEE PHYSICIAN SERVICES, LLC
Active
Other names
United Telehealth Services
Organization subpart
No
Provider details
NPI number
Authorized official
DEB GOTT (DIRECTOR OF PROGRAM MANAGEMENT)
(800) 301-6254
Entity
Organization
Contact information
Practice address
1499 FAIR RD, STATESBORO, GA 30458-1683
(800) 301-6254
(888) 972-5992
Mailing address
5050 THOROUGHBRED LANE, SUITE C, BRENTWOOD, TN 37027
(800) 301-6254
(888) 972-5992
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181293A
—
GA
Enumeration date
05/08/2012
Last updated
02/14/2024
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