Provider Demographics
NPI:1760029227
Name:PHYSICIANS GROUP PLLC
Entity Type:Organization
Organization Name:PHYSICIANS GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSHRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-566-7741
Mailing Address - Street 1:2042 TOWN CENTER BLVD # 325
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6677
Mailing Address - Country:US
Mailing Address - Phone:865-314-7125
Mailing Address - Fax:865-247-4478
Practice Address - Street 1:3118 ALCOA HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-4791
Practice Address - Country:US
Practice Address - Phone:865-314-7125
Practice Address - Fax:865-247-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty