Healthcare Provider Details

I. General information

NPI: 1700454402
Provider Name (Legal Business Name): EHG OF TENNESSEE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 TROTWOOD AVE
COLUMBIA TN
38401-6436
US

IV. Provider business mailing address

1A BURTON HILLS BLVD
NASHVILLE TN
37215-6187
US

V. Phone/Fax

Practice location:
  • Phone: 931-388-8302
  • Fax: 931-388-9540
Mailing address:
  • Phone: 615-263-5579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK J SLEPIN
Title or Position: PRESIDENT
Credential:
Phone: 866-459-8701