| Tullahoma Neurodiagnostic Clinic Pc | |
|
1330 Cedar Ln Suite 700 Tullahoma TN 37388-2283 | |
| (931) 455-1219 | |
| (931) 393-3394 |
| Full Name | Tullahoma Neurodiagnostic Clinic Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1330 Cedar Ln, Tullahoma, Tennessee |
| Authorized Official Name and Position | Raymond L Capps (PHYSICIAN) |
| Authorized Official Contact | 9314551219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tullahoma Neurodiagnostic Clinic Pc 1330 Cedar Ln Suite 700 Tullahoma TN 37388-2283 Ph: (931) 455-1219 | Tullahoma Neurodiagnostic Clinic Pc 1330 Cedar Ln Suite 700 Tullahoma TN 37388-2283 Ph: (931) 455-1219 |
| NPI Number | 1548249527 |
|---|---|
| Provider Enumeration Date | 01/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548249527 | NPI | - | NPPES |
| 3726745 | Medicaid | TN | |
| 3115407 | Other | TN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 30044 (Tennessee) | Primary |
Tullahoma City Schools Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 S Jackson St, Tullahoma, TN 37388 Phone: 931-454-2639 | |
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