Provider Demographics
NPI:1922331842
Name:PHYSICIAN SERVICES OF MIDDLE TENNESSEE, LLC
Entity Type:Organization
Organization Name:PHYSICIAN SERVICES OF MIDDLE TENNESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUTF
Authorized Official - Middle Name:U
Authorized Official - Last Name:REHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-390-6775
Mailing Address - Street 1:1105 ROLLING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8495
Mailing Address - Country:US
Mailing Address - Phone:615-390-6775
Mailing Address - Fax:615-834-2053
Practice Address - Street 1:1414 COUNTY HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3023
Practice Address - Country:US
Practice Address - Phone:615-862-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty