Organization
WHITE COUNTY PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL S SLIPKOVICH (CEO)
(615) 764-3049
Entity
Organization
Contact information
Practice address
401 SEWELL DR, SPARTA, TN 38583-1223
(931) 738-4347
(931) 738-9236
Mailing address
401 SEWELL DR, SPARTA, TN 38583-1223
(931) 738-4347
(931) 738-9236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3708493
—
TN
Enumeration date
09/30/2009
Last updated
09/09/2013
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