Provider Demographics
NPI:1306609748
Name:UNIVERSITY HEALTH SYSTEM INC
Entity type:Organization
Organization Name:UNIVERSITY HEALTH SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT TEAM LEAD
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-670-6754
Mailing Address - Street 1:9000 EXECUTIVE PARK DR STE C200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4644
Mailing Address - Country:US
Mailing Address - Phone:865-670-6754
Mailing Address - Fax:865-670-6142
Practice Address - Street 1:1926 ALCOA HWY STE F210
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1545
Practice Address - Country:US
Practice Address - Phone:865-670-6754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty