| Ut Med Group | |
|
1894 Cedar St Mc Kenzie TN 38201-2206 | |
| (731) 352-0603 | |
| (731) 352-0185 |
| Full Name | Ut Med Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1894 Cedar St, Mc Kenzie, Tennessee |
| Authorized Official Name and Position | Daniel D Sumrok (MD) |
| Authorized Official Contact | 7313520603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ut Med Group 1894 Cedar St Mc Kenzie TN 38201-2206 Ph: (731) 352-0603 | Ut Med Group 1894 Cedar St Mc Kenzie TN 38201-2206 Ph: (731) 352-0603 |
| NPI Number | 1902966153 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 04/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902966153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD21860 (Tennessee) | Primary |
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