Provider Demographics
NPI:1700807658
Name:HEATH, SYRIA HASSAN (MD)
Entity Type:Individual
Prefix:
First Name:SYRIA
Middle Name:HASSAN
Last Name:HEATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 DECATUR PIKE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-2418
Mailing Address - Country:US
Mailing Address - Phone:423-746-1415
Mailing Address - Fax:423-745-6413
Practice Address - Street 1:1320 DECATUR PIKE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2418
Practice Address - Country:US
Practice Address - Phone:423-746-1415
Practice Address - Fax:423-745-6413
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD 0000034333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine