Provider Demographics
NPI:1942569249
Name:TERESA G. HUGGINS, MD
Entity Type:Organization
Organization Name:TERESA G. HUGGINS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-355-0100
Mailing Address - Street 1:211 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3024
Mailing Address - Country:US
Mailing Address - Phone:615-355-0100
Mailing Address - Fax:615-355-0684
Practice Address - Street 1:211 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3024
Practice Address - Country:US
Practice Address - Phone:615-355-0100
Practice Address - Fax:615-355-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000013586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3009930Medicare PIN
TNA97420Medicare UPIN