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902 Hwy 13 S Collinwood TN 38450-0215 | |
(931) 724-9135 | |
(931) 724-4572 |
Full Name | |
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Speciality | Family Medicine |
Location | 902 Hwy 13 S, Collinwood, Tennessee |
Authorized Official Name and Position | David Mandresa Magas (OWNER) |
Authorized Official Contact | 9317249135 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 215 902 Hwy 13 S Collinwood TN 38450-0215 Ph: (931) 724-9135 | 902 Hwy 13 S Collinwood TN 38450-0215 Ph: (931) 724-9135 |
NPI Number | 1750446829 |
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Provider Enumeration Date | 12/27/2006 |
Last Update Date | 06/29/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750446829 | NPI | - | NPPES |
3028025 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 17846 (Tennessee) | Primary |