Organization
BSA PHYSICIANS GROUP INC
Active
Parent organization
BSA PHYSICIAN HOLDING COMPANY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BSA PHYSICIAN HOLDING COMPANY LLC
Authorized official
STEPHEN C PETROVICH (SVP)
(615) 296-3000
Entity
Organization
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(806) 212-6965
(806) 212-6278
Mailing address
1 BURTON HILLS BLVD STE 250, NASHVILLE, TN 37215-6195
(615) 296-3000
(615) 296-6011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2012
Last updated
12/17/2012
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