Provider Demographics
NPI:1851538417
Name:SOUTHERN TENNESSEE INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:SOUTHERN TENNESSEE INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:HUAQING
Authorized Official - Last Name:YE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-962-3500
Mailing Address - Street 1:PO BOX 705
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-0705
Mailing Address - Country:US
Mailing Address - Phone:931-962-3500
Mailing Address - Fax:931-962-3545
Practice Address - Street 1:1383 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2414
Practice Address - Country:US
Practice Address - Phone:931-962-3500
Practice Address - Fax:931-962-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-18
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44409261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care