Provider Demographics
NPI:1366008153
Name:HEALTHSTAR PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:HEALTHSTAR PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ODESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRABSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-581-5925
Mailing Address - Street 1:420 W MORRIS BLVD STE 400A
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2262
Mailing Address - Country:US
Mailing Address - Phone:423-581-5925
Mailing Address - Fax:423-581-2828
Practice Address - Street 1:150 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2329
Practice Address - Country:US
Practice Address - Phone:423-237-6900
Practice Address - Fax:423-237-6899
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHSTAR PHYSICIANS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty