Healthcare Provider Details

I. General information

NPI: 1154629459
Provider Name (Legal Business Name): TENNESSEE PHYSICIAN CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 CLEVELAND ST
CROSSVILLE TN
38555-9716
US

IV. Provider business mailing address

PO BOX 602561
CHARLOTTE NC
28260-2561
US

V. Phone/Fax

Practice location:
  • Phone: 931-787-1835
  • Fax: 931-787-1863
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: EARL LYNN PHILLIPS
Title or Position: PRESIDENT
Credential: MD
Phone: 866-885-5522