Provider Demographics
NPI:1194839498
Name:HUGGINS, TERESA GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:GAIL
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3024
Mailing Address - Country:US
Mailing Address - Phone:615-355-0100
Mailing Address - Fax:615-355-0684
Practice Address - Street 1:211 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3024
Practice Address - Country:US
Practice Address - Phone:615-355-0100
Practice Address - Fax:615-355-0684
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000013586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3009930Medicaid
TNA97420Medicare UPIN
TN3009930Medicaid