Basic Information
| Provider Information | |||||||||
| NPI: | 1609801000 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEINLY MCCULLEY | ||||||||
| FirstName: | TAMMY | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7205 WOLF RIVER BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017576100 | ||||||||
| FaxNumber: | 9017576109 | ||||||||
| Practice Location | |||||||||
| Address1: | 7205 WOLF RIVER BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017576100 | ||||||||
| FaxNumber: | 9017576109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 11/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | MD026216 | TN | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.