Organization
SUMMIT MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM E BAUCOM III MD (PRESIDENT)
(615) 391-3971
Entity
Organization
Contact information
Practice address
5653 FRIST BLVD, SUITE 630, HERMITAGE, TN 37076-2094
(615) 391-3971
(615) 391-3867
Mailing address
5653 FRIST BLVD, SUITE 630, HERMITAGE, TN 37076-2094
(615) 391-3971
(615) 391-3867
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201049
BCBS
TN
01
—
CA1799
R/R MEDICARE
TN
Enumeration date
06/25/2006
Last updated
10/28/2011
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