| Interstate Health Systems, Inc | |
|
315 N Washington Ave Ste 190 Cookeville TN 38501-5984 | |
| (931) 526-1604 | |
| Not Available |
| Full Name | Interstate Health Systems, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 315 N Washington Ave Ste 190, Cookeville, Tennessee |
| Authorized Official Name and Position | Jeff Seraphine (CEO) |
| Authorized Official Contact | 9315261604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interstate Health Systems, Inc 330 Franklin Rd Ste 135a-160 Brentwood TN 37027-3280 Ph: () - | Interstate Health Systems, Inc 315 N Washington Ave Ste 190 Cookeville TN 38501-5984 Ph: (931) 526-1604 |
| NPI Number | 1073216990 |
|---|---|
| Provider Enumeration Date | 03/22/2023 |
| Last Update Date | 08/18/2023 |
| Medicare PECOS PAC ID | 0749634939 |
|---|---|
| Medicare Enrollment ID | O20230921001784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073216990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Katherine Jean Tura Spencer-schuerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043879935 PECOS PAC ID: 9739419839 Enrollment ID: I20191002001420 |
| Provider Name | Toney Hudson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063418911 PECOS PAC ID: 8527231281 Enrollment ID: I20231005001881 |
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