Organization Name:  PHYSICIANS PAVILION LP


Practice Location:
545 STONECREST PKWY  SMYRNA, TN 37167 US
Tel: 615-220-3720  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	TN	0000000065

Other Provider Identifiers:

Issuer	Number	State	Type
	3287552	TN	05
RAILROAD MEDICARE	490002245	TN	01
BLUE CROSS PROVIDER NUMBE	1000923	TN	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin