Organization
PRIVIA MEDICAL GROUP TENNESSEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ROLLER (ASSOCIATE DIRECTOR/ENROLLMENT)
(770) 312-5226
Entity
Organization
Contact information
Practice address
1 VANTAGE WAY STE C240, NASHVILLE, TN 37228-1580
(571) 982-6636
(240) 696-1353
Mailing address
950 N GLEBE RD STE 700, ARLINGTON, VA 22203-4173
(571) 982-6636
(240) 696-1353
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
06/04/2021
Last updated
08/16/2022
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