Provider Demographics
NPI:1346460409
Name:UNIVERSITY TENNESSEE HEALTH SCIENCE CENTER
Entity Type:Organization
Organization Name:UNIVERSITY TENNESSEE HEALTH SCIENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN PEDIATRIC OTOLARYNGOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:W
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-448-5886
Mailing Address - Street 1:68 S MENDENHALL RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-3318
Mailing Address - Country:US
Mailing Address - Phone:901-730-0260
Mailing Address - Fax:
Practice Address - Street 1:UT COLLEGE OF MEDICINE
Practice Address - Street 2:920 MADISON AVENUE SUITE C 50
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-448-5364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN281PC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281PC2000XHospitalsChronic Disease HospitalChildren