Amg -Southern Tennessee LLC

NPI #1699792390 in Monteagle, Tennessee

Provider Information

NPI Number: 1699792390
Entity Type: Organization
Organization Name: Amg -Southern Tennessee LLC
Subpart: Yes (part of a larger organization)
Parent Organization: AMG-SOUTHERN TENNESSEE LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 17, 2006
Last Updated: Apr 20, 2008

Practice Location

Address: 15 S CENTRAL AVE
City: Monteagle
State: Tennessee
ZIP Code: 37356-3074
Phone: (931) 924-4045

Authorized Official

Name: WILLIAM GRACEY
Title: CEO
Phone: (615) 372-8500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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