Organization
PUTNAM EMERGENCY PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LARSEN (DIRECTOR OF CREDENTIALING)
(770) 874-5400
Entity
Organization
Contact information
Practice address
1 MEDICAL CENTER BLVD, COOKEVILLE, TN 38501-4294
(931) 528-2541
Mailing address
5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA 30328-5834
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/24/2023
Last updated
11/14/2023
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