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TENNESSEE PHYSICIAN SERVICES LLC NPI 1316206535


NPI Information

NPI: 1316206535
Provider Name: TENNESSEE PHYSICIAN SERVICES, LLC

Doing Business As: UNITED TELEHEALTH SERVICES

Classification: Pediatrics - 2080N0001X
Entity Type: Organization

Specialization: Neonatal-Perinatal Medicine

CLIA Number: 44D2278890

Address:
1499 FAIR RD
STATESBORO, GA
ZIP 30458
Phone: (800) 301-6254
Get Directions

TENNESSEE PHYSICIAN SERVICES, LLC is a neonatal-perinatal medicine pediatrics in Statesboro, GA. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. TENNESSEE PHYSICIAN SERVICES, LLC NPI is 1316206535. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As United Telehealth Services.

The provider's business location address is:

1499 FAIR RD
STATESBORO, GA
ZIP 30458-683
Phone: (800) 301-6254
Fax: (888) 972-5992

The provider's authorized official is Deb Gott .
The authorized official title is Director Of Program Management and has the following contact phone number (800) 301-6254.

The CLIA number assigned to this NPI record is 44D2278890 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/8/2012 and was last updated on 2/14/2024.


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
1207VM0101XObstetrics & GynecologyMaternal & Fetal MedicineNo
2363LF0000XNurse PractitionerFamilyNo
3363LN0000XNurse PractitionerNeonatalNo
4363LP0200XNurse PractitionerPediatricsNo
52080N0001XPediatricsNeonatal-Perinatal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003181293AMEDICAIDGEORGIA

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

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