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630 Broadmor St Ste 140 Murfreesboro TN 37129-2787 | |
| (615) 281-6844 | |
| (615) 281-6848 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 630 Broadmor St Ste 140, Murfreesboro, Tennessee |
| Authorized Official Name and Position | Jay Higham (CEO) |
| Authorized Official Contact | 2143656100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
5001 Spring Valley Road Suite 600 East Dallas TX 75244 Ph: (214) 365-6100 | 630 Broadmor St Ste 140 Murfreesboro TN 37129-2787 Ph: (615) 281-6844 |
| NPI Number | 1194398974 |
|---|---|
| Provider Enumeration Date | 07/20/2021 |
| Last Update Date | 12/26/2024 |
| Certification Date | 12/26/2024 |
| Medicare PECOS PAC ID | 5092101956 |
|---|---|
| Medicare Enrollment ID | O20220404000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194398974 | NPI | - | NPPES |
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