Provider Demographics
NPI:1659640803
Name:TROUSDALE PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:TROUSDALE PHYSICIAN PRACTICES LLC
Other - Org Name:DBA: TROUSDALE FAMILY PRACTICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-695-1544
Mailing Address - Street 1:502 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-1744
Mailing Address - Country:US
Mailing Address - Phone:615-374-9991
Mailing Address - Fax:615-374-9992
Practice Address - Street 1:502 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1744
Practice Address - Country:US
Practice Address - Phone:615-374-9991
Practice Address - Fax:615-374-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty