Basic Information
Provider Information
NPI: 1760840763
EntityType: 2
ReplacementNPI:  
OrganizationName: BETTER LIFE MEDICAL PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: TENNESSEE MEN'S HEALTH CLINIC
OtherOrganizationType: 3
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1326 PAPERMILL POINTE WAY
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379091903
CountryCode: US
TelephoneNumber: 6154034546
FaxNumber: 4092270500
Practice Location
Address1: 1328 PAPERMILL POINTE WAY
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379091903
CountryCode: US
TelephoneNumber: 8652888947
FaxNumber: 8652432138
Other Information
ProviderEnumerationDate: 02/04/2016
LastUpdateDate: 04/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TIPTON
AuthorizedOfficialFirstName: MARGARET
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CREDENTIALER
AuthorizedOfficialTelephone: 8652432136
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansUrology 

No ID Information.


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