Provider Demographics
NPI:1962662270
Name:PREMIER INTERNAL MEDICINE OF GILES COUNTY, PLLC
Entity Type:Organization
Organization Name:PREMIER INTERNAL MEDICINE OF GILES COUNTY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CLEMENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALUYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-397-3312
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:1119 E COLLEGE ST STE 1
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-4556
Mailing Address - Country:US
Mailing Address - Phone:931-207-8630
Mailing Address - Fax:931-207-8629
Practice Address - Street 1:1119 E COLLEGE ST STE 1
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4556
Practice Address - Country:US
Practice Address - Phone:931-207-8630
Practice Address - Fax:931-207-8629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1505336Medicaid
TN30022572Medicare PIN