Provider Demographics
NPI:1114071057
Name:SAVAGE, STEPHEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3502
Mailing Address - Country:US
Mailing Address - Phone:931-527-9999
Mailing Address - Fax:931-527-9999
Practice Address - Street 1:1119 EAST COLLEGE STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478
Practice Address - Country:US
Practice Address - Phone:931-424-8881
Practice Address - Fax:931-424-5385
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN019384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3051287Medicaid
D91471Medicare UPIN
TN3051287Medicare ID - Type Unspecified