Provider Demographics
NPI:1356629752
Name:UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN OF STUDENTS
Authorized Official - Prefix:MS
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-448-4772
Mailing Address - Street 1:4737 LAHR RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172
Mailing Address - Country:US
Mailing Address - Phone:615-720-5588
Mailing Address - Fax:
Practice Address - Street 1:4737 LAHR RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-7125
Practice Address - Country:US
Practice Address - Phone:615-720-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital