Provider Demographics
NPI:1770208118
Name:PRIORITY HEALTH & ADDICTION MEDICINE
Entity type:Organization
Organization Name:PRIORITY HEALTH & ADDICTION MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-507-0707
Mailing Address - Street 1:1509 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5625
Mailing Address - Country:US
Mailing Address - Phone:731-507-0707
Mailing Address - Fax:731-389-9446
Practice Address - Street 1:1117 S MILES AVE STE 4
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5439
Practice Address - Country:US
Practice Address - Phone:731-507-0707
Practice Address - Fax:731-389-9446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty