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General NPI Number Information
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NPI Number | 1578001608
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Entity Type | Organization
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Legal Business Name | USAC-3 LLC
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 03/12/2017
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Provider Practice Location Address
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Address Line | 174 SAUNDERSVILLE RD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-8945
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Country | US
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Telephone | 917-410-6933
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Fax | 917-768-0799
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Provider Business Mailing Address
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Address Line | 174 SAUNDERSVILLE RD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-8945
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Country | US
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Telephone | 917-410-6933
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Fax | 917-768-0799
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MR. ASIF ALI
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Credential |
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Telephone | 732-703-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 23572
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License Number State | TN
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