| Mid South Psychiatric Associates | |
|
1830 Heritage Park Plz Murfreesboro TN 37129-1575 | |
| (615) 895-8104 | |
| (615) 895-7903 |
| Full Name | Mid South Psychiatric Associates |
|---|---|
| Speciality | Psychologist |
| Location | 1830 Heritage Park Plz, Murfreesboro, Tennessee |
| Authorized Official Name and Position | Ahmed I Farooque (PARTNER) |
| Authorized Official Contact | 6158958104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid South Psychiatric Associates 1830 Heritage Park Plz Murfreesboro TN 37129-1575 Ph: (615) 895-8104 | Mid South Psychiatric Associates 1830 Heritage Park Plz Murfreesboro TN 37129-1575 Ph: (615) 895-8104 |
| NPI Number | 1013109511 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 08/17/2007 |
| Medicare PECOS PAC ID | 3678556867 |
|---|---|
| Medicare Enrollment ID | O20040609000805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013109511 | NPI | - | NPPES |
| 1861608895 | Other | NPI | |
| 3706880 | Medicaid | TN | |
| 1558479170 | Other | NPI | |
| 1922116649 | Other | NPI |
| Provider Name | Ahmed I Farooque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558479170 PECOS PAC ID: 7113900317 Enrollment ID: I20100824000362 |
| Provider Name | Ravi P Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922116649 PECOS PAC ID: 5294859542 Enrollment ID: I20100824000599 |
| Provider Name | Lori L Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356848196 PECOS PAC ID: 1759623325 Enrollment ID: I20190501000231 |
| Provider Name | Katelyn C Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417565565 PECOS PAC ID: 9335553494 Enrollment ID: I20210201001279 |
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