| |
307 F West Main St, Lebanon, TN 37087 | |
(615) 449-4151 | |
(615) 449-1994 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 307 F West Main St, Lebanon, Tennessee |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902905573 | NPI | - | NPPES |
P4110444 | Other | TN | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 1874DC (Tennessee) | Secondary |
207Q00000X | Family Medicine | 7162 (Tennessee) | Primary |
363A00000X | Physician Assistant | 1192PA (Tennessee) | Secondary |
Mailing Address | Practice Location Address |
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307 F West Main St, Po Box 3322, Lebanon, TN 37087 Ph: (615) 449-4151 | 307 F West Main St, Lebanon, TN 37087 Ph: (615) 449-4151 |