Provider Demographics
NPI:1861515397
Name:SATELLITE MED, PLLC
Entity type:Organization
Organization Name:SATELLITE MED, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN KERKHOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-975-8613
Mailing Address - Street 1:1120 SAMS ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-4006
Mailing Address - Country:US
Mailing Address - Phone:931-528-7312
Mailing Address - Fax:
Practice Address - Street 1:1120 SAMS ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4006
Practice Address - Country:US
Practice Address - Phone:931-528-7312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
TN261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty