MEDICARE: TNT MEDICAL ENTERPRISES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1104331420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TNT MEDICAL ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	609 MAGNOLIA VALE DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37419-2185
Country	:	US
Telephone Number	:	423-987-3702
Fax Number	:	423-825-1992

Provider Business Practice Location Address
First Line	:	609 MAGNOLIA VALE DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37419-2185
Country	:	US
Telephone Number	:	423-987-3702
Fax Number	:	423-825-1992

Authorized Official
Title or Position	:	OWNER/MEDICAL DOCTOR
Name	:	TERRI JONES
Credential	:	MD
Telephone Number	:	423-987-3702

Provider Enumeration Date	:	12/08/2017
Last Update Date	:	12/08/2017

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