Specialty Physician Group Llc

LBN: Specialty Physician Group Llc
Specialty Physician Group Llc is an health care organization with primary practice located at 7460 Wolf River Blvd , Germantown TN 38138-1760. The organization recently has 10 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Cardiovascular Disease is the primary health care specialty. Specialty Physician Group Llc can be contacted via phone (901) 763-0200, or through Lane, Charles R via phone (901) 478-0525.

Contact Information

Primary practice address
7460 Wolf River Blvd Germantown TN 38138-1760
Phone: (901) 763-0200
Fax: (901) 761-4002
Website:
Map and Directions
Authorized official contact:
Name: Lane, Charles R
Phone: (901) 478-0525

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1174842181
LBN Legal business name Specialty Physician Group Llc
DBA Doing business as
Authorized official Lane, Charles R
Entity Organization
Organization subpart 1 No
Enumeration date Jun 1st, 2010
Last updated Jun 6th, 2024 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174842181 NPPES
Arkansas MEDICAID 183763002
Arkansas MEDICAID 1519260
Arkansas Other 4269952

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