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NPI 1740277821

NPI 1740277821 : TRANSSOUTH HEALTH CARE PLLC : JACKSON, TN

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General NPI Number Information
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    NPI Number           |    1740277821
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRANSSOUTH HEALTH CARE PLLC 
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Dates
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    Enumeration Date     |    10/04/2005
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    Last Update Date     |    03/10/2025
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Provider Practice Location Address
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    Address Line         |    9 PHYSICIANS DR 
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    City                 |    JACKSON
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    State                |    TN
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    Zip                  |    38305-2071
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    Country              |    US
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    Telephone            |    731-661-0086
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    Fax                  |    731-661-0281
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Provider Business Mailing Address
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    Address Line         |    ONE GI CREDENTIALING DEPARTMENT PO BOX 381468
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    City                 |    GERMANTOWN
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    State                |    TN
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    Zip                  |    38183-1468
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR, CREDENTIALING
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    Name                 |     AIMEE CATHLEEN JUDY 
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    Credential           |    
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    Telephone            |    901-737-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QA1903X
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    Taxonomy Name        |    Ambulatory Surgical Clinic/Center
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    License Number       |    0000000070
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    License Number State |    TN
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