MEDICARE: HEALTHSTAR PHYSICIANS, P.C.

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	:	1366008153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHSTAR PHYSICIANS, P.C.

Provider Business Mailing Address
First Line	:	420 W MORRIS BLVD STE 400A
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37813-2262
Country	:	US
Telephone Number	:	423-581-5925
Fax Number	:	423-581-2828

Provider Business Practice Location Address
First Line	:	150 E BROADWAY
Second Line	:
City	:	NEWPORT
State	:	TN
Zip	:	37821-2329
Country	:	US
Telephone Number	:	423-237-6900
Fax Number	:	423-237-6899

Authorized Official
Title or Position	:	CFO
Name	:	ODESSA BRABSON
Credential	:
Telephone Number	:	423-581-5925

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	05/16/2019

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