Provider Demographics
NPI:1619060860
Name:UNIVERSITY OBGYN ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:UNIVERSITY OBGYN ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIRMALA
Authorized Official - Middle Name:B
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-305-9305
Mailing Address - Street 1:PO BOX 440032
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0032
Mailing Address - Country:US
Mailing Address - Phone:865-670-6750
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:STE 303
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1502
Practice Address - Country:US
Practice Address - Phone:865-670-6750
Practice Address - Fax:865-305-6588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3732346Medicaid
TN3732346Medicare PIN
TN3732346Medicaid