Provider Demographics
NPI:1477919306
Name:ADVANCED SURGICAL CARE OF TENNESSEE
Entity Type:Organization
Organization Name:ADVANCED SURGICAL CARE OF TENNESSEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:KLEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-823-4045
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-0008
Mailing Address - Country:US
Mailing Address - Phone:931-823-4045
Mailing Address - Fax:931-823-4059
Practice Address - Street 1:502 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1718
Practice Address - Country:US
Practice Address - Phone:931-823-4045
Practice Address - Fax:931-823-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty