Provider Demographics
NPI:1194008474
Name:UNIVERSITY HEALTH SYSTEM, INC
Entity type:Organization
Organization Name:UNIVERSITY HEALTH SYSTEM, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARQUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-305-9886
Mailing Address - Street 1:PO BOX 440105
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0105
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6188
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:STE 102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1502
Practice Address - Country:US
Practice Address - Phone:865-305-6640
Practice Address - Fax:865-305-6745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525461Medicaid
TN103G709838Medicare PIN