| Advanced Family Medical Center | |
|
101 Main St N Middleton TN 38052-3433 | |
| (731) 472-2147 | |
| (731) 472-2148 |
| Full Name | Advanced Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 Main St N, Middleton, Tennessee |
| Authorized Official Name and Position | William V Caicedo (NP) |
| Authorized Official Contact | 7315187391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Medical Center 101 Main St N Middleton TN 38052-3433 Ph: (731) 472-2147 | Advanced Family Medical Center 101 Main St N Middleton TN 38052-3433 Ph: (731) 472-2147 |
| NPI Number | 1467957126 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 02/08/2019 |
| Medicare PECOS PAC ID | 2961755913 |
|---|---|
| Medicare Enrollment ID | O20181022002238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467957126 | NPI | - | NPPES |
| Q001019 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 17787 (Tennessee) | Secondary |
| Provider Name | William V Caicedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851732259 PECOS PAC ID: 9739322686 Enrollment ID: I20130826000568 |
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