Tullahoma Urology Center, P.L.L.C.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

40439 Issued in TN

Legal business name

TULLAHOMA UROLOGY CENTER, P.L.L.C.

Practice address

107 Ledford Mill Rd
Suite 210
Tullahoma, TN 37388-2278

Phone

(931) 454-1955

Fax

(931) 454-1956

NPI assigned

Nov 15, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Lloyd Burson, M.D.

Title

Owner

Phone

(931) 454-1955

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1720060841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1718",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373881718",
            "telephone_number": "931-454-1955",
            "fax_number": "931-454-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 LEDFORD MILL RD",
            "address_2": "SUITE 210",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882278",
            "telephone_number": "931-454-1955",
            "fax_number": "931-454-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULLAHOMA UROLOGY CENTER, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "BURSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-454-1955",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "TN",
            "license": "40439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/TN",
            "identifier": "4116328",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tullahoma Pediatric Therapy, LLC
• Tullahoma Pediatrics PLLC
• Tullahoma Physicians Group, PLLC
• Tullahoma Sleep Disorder Center
• Tullahoma Spine & Wellness
• Tullahoma Vision Associates P C
• Tullahoma Women'S Health
• Pam Turner, B.S.
• Tara Beth Tye, NP-C
• Urgent Urgent America, LLC

• Urology Physician in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.