Provider Demographics
NPI:1285769463
Name:GRANDVIEW PHYSICIAN GROUP LLC
Entity type:Organization
Organization Name:GRANDVIEW PHYSICIAN GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-764-3007
Mailing Address - Street 1:501 CORPORATE CENTRE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2659
Mailing Address - Country:US
Mailing Address - Phone:615-764-3000
Mailing Address - Fax:615-764-3038
Practice Address - Street 1:980 HIGHWAY 28
Practice Address - Street 2:SUITE 102
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3695
Practice Address - Country:US
Practice Address - Phone:423-837-9500
Practice Address - Fax:423-837-3333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPELLA HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-21
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty