Provider Demographics
NPI:1457473290
Name:MIDDLE TENN ENT SPECIALISTS
Entity Type:Organization
Organization Name:MIDDLE TENN ENT SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-380-9166
Mailing Address - Street 1:927 N JAMES CAMPBELL BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6422
Mailing Address - Country:US
Mailing Address - Phone:931-380-9166
Mailing Address - Fax:931-388-4105
Practice Address - Street 1:927 N JAMES CAMPBELL BLVD
Practice Address - Street 2:STE 101
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6422
Practice Address - Country:US
Practice Address - Phone:931-380-9166
Practice Address - Fax:931-388-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3719080Medicare PIN