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WEST TENNESSEE MEDICAL GROUP INC NPI 1053615955


NPI Information

NPI: 1053615955
Provider Name: WEST TENNESSEE MEDICAL GROUP INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 44D2162188

Address:
620 SKYLINE DR
JACKSON, TN
ZIP 38301
Phone: (731) 660-8730
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WEST TENNESSEE MEDICAL GROUP INC is an internal medicine in Jackson, TN. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. WEST TENNESSEE MEDICAL GROUP INC NPI is 1053615955. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

620 SKYLINE DR
JACKSON, TN
ZIP 38301-923
Phone: (731) 660-8730
Fax: (731) 660-8739

The provider's authorized official is Bartley Teague .
The authorized official title is Executive Director and has the following contact phone number (731) 512-1277.

The CLIA number assigned to this NPI record is 44D2162188 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2011 and was last updated on 12/20/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207T00000XNeurological SurgeryNo
3207V00000XObstetrics & GynecologyNo
4208000000XPediatricsNo
5208100000XPhysical Medicine & RehabilitationNo
62084N0400XPsychiatry & NeurologyNeurologyNo
72084S0012XPsychiatry & NeurologySleep MedicineNo
82086S0127XSurgeryTrauma SurgeryNo
9208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
10208M00000XHospitalistNo
11207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.