Provider Demographics
NPI:1780777334
Name:TRANSMEDICUS SERVICE CORPORATION
Entity type:Organization
Organization Name:TRANSMEDICUS SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:LIDDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-428-4042
Mailing Address - Street 1:1240 FOX MEADOWS BOULEVARD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6928
Mailing Address - Country:US
Mailing Address - Phone:865-428-4042
Mailing Address - Fax:865-428-8191
Practice Address - Street 1:1240 FOX MEADOWS BOULEVARD
Practice Address - Street 2:SUITE 6
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6928
Practice Address - Country:US
Practice Address - Phone:865-428-4042
Practice Address - Fax:865-428-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38043802Medicaid