Provider Demographics
NPI:1275697633
Name:UNIVERSITY HEALTH SYSTEM, INC
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH SYSTEM, INC
Other - Org Name:U.T. FAMILY PHYSICIANS ALCOA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARQUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-690-2992
Mailing Address - Street 1:281 CUSICK RD
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-3127
Mailing Address - Country:US
Mailing Address - Phone:865-970-0025
Mailing Address - Fax:865-970-2089
Practice Address - Street 1:281 CUSICK RD
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-3127
Practice Address - Country:US
Practice Address - Phone:865-970-0025
Practice Address - Fax:865-970-2089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3707500Medicare ID - Type Unspecified