Organization
AMG-HILLSIDE LLC
Active
Other names
Urology Associates of South Central TN
Organization subpart
No
Provider details
NPI number
Authorized official
JESS JUDY (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
600 E COLLEGE ST, PULASKI, TN 38478-4407
(931) 363-1464
(931) 363-2368
Mailing address
PO BOX 715, PULASKI, TN 38478-0715
(931) 363-9438
(931) 363-9430
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
43985
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3153524
BCBS TN
TN
01
—
CK2947
RR MEDICARE
—
Enumeration date
12/10/2009
Last updated
04/15/2010
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