Red Spruce Emergency Physicians, PLLC

Organization Active NPI Emergency Medicine Physician · Portland, TN

NPI 1962860064 · NPPES record last updated Feb 3, 2016

Key facts

NPI
1962860064
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
RED SPRUCE EMERGENCY PHYSICIANS, PLLC
Practice address
105 Redbud Dr
Portland, TN 37148-1673
Phone
(469) 401-2386
NPI assigned
Feb 3, 2016
Organization subpart
No

Authorized official

Name
Terry Meadows, M.D.
Title
Officer
Phone
(469) 401-2386

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Red Spruce Emergency Physicians LLC (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

105 Redbud Dr
Portland, TN 37148-1673

Mailing address

PO Box 80103
Philadelphia, PA 19101-1103

Other providers in Portland, TN

All providers in Portland, TN · Emergency Medicine Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.