Provider Demographics
NPI:1861607251
Name:UNIVERISTY OF TENNESSEE, STUDENT HEALTH SERVICE
Entity type:Organization
Organization Name:UNIVERISTY OF TENNESSEE, STUDENT HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:865-974-2253
Mailing Address - Street 1:1818 ANDY HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-3135
Mailing Address - Fax:865-974-2000
Practice Address - Street 1:1818 ANDY HOLT AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-3135
Practice Address - Fax:865-974-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health