Provider Demographics
NPI:1326919200
Name:UT MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:UT MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:KNOP
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-866-8105
Mailing Address - Street 1:930 MADISON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3452
Mailing Address - Country:US
Mailing Address - Phone:901-448-6650
Mailing Address - Fax:901-302-2486
Practice Address - Street 1:930 MADISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3452
Practice Address - Country:US
Practice Address - Phone:901-448-6650
Practice Address - Fax:901-302-2486
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UT MEDICAL GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty