Organization
SHC MEDICAL PARTNERS OF TENNESSEE, LLC
Active
Parent organization
SHC MEDICAL PARTNERS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHC MEDICAL PARTNERS, LLC
Authorized official
PENNY CAROL LOGAN (CHIEF OPERATING OFFICER)
(502) 558-2193
Entity
Organization
Contact information
Practice address
919 MEDICAL PARK DR, MOUNTAIN CITY, TN 37683-1042
(423) 727-7800
(423) 727-2498
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 630-7532
(502) 568-7121
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0564617
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1506049
GROUP MEDICAID NUMBER
TN
Enumeration date
01/07/2008
Last updated
07/26/2023
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