Basic Information
| Provider Information | |||||||||
| NPI: | 1942938113 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMNER PHYSICIAN PRACTICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 SEVEN SPRINGS WAY | ||||||||
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| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159207000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 133 HOSPITAL DR STE 500 | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370304020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157350700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2022 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | DILLON | ||||||||
| AuthorizedOfficialFirstName: | TERRANCE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSISTANT SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 6159207000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.