Provider Demographics
NPI:1871823989
Name:AMERICAN MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-730-1229
Mailing Address - Street 1:315 S WALNUT BEND RD
Mailing Address - Street 2:CORDOVA
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 S WALNUT BEND RD
Practice Address - Street 2:CORDOVA
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7216
Practice Address - Country:US
Practice Address - Phone:901-219-6840
Practice Address - Fax:901-219-6740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31930207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty