| Cornerstone Family Medicine Llc | |
|
433 Sewell Dr Sparta TN 38583-1223 | |
| (931) 739-3000 | |
| (931) 739-3013 |
| Full Name | Cornerstone Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 433 Sewell Dr, Sparta, Tennessee |
| Authorized Official Name and Position | Chad A Griffin (OWNER) |
| Authorized Official Contact | 9317393000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Family Medicine Llc 433 Sewell Dr Sparta TN 38583-1223 Ph: (931) 739-3000 | Cornerstone Family Medicine Llc 433 Sewell Dr Sparta TN 38583-1223 Ph: (931) 739-3000 |
| NPI Number | 1679503841 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 11/05/2010 |
| Medicare PECOS PAC ID | 5799792404 |
|---|---|
| Medicare Enrollment ID | O20060321000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679503841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD28253 (Tennessee) | Primary |
| Provider Name | Anna V Benningfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295977882 PECOS PAC ID: 3173672540 Enrollment ID: I20090514000620 |
| Provider Name | Chad Aubrey Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659311702 PECOS PAC ID: 6507873213 Enrollment ID: I20100429000438 |
| Provider Name | Laura Rene Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053618074 PECOS PAC ID: 0042484784 Enrollment ID: I20150205000789 |
| Provider Name | Kelly L Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396143483 PECOS PAC ID: 3870819923 Enrollment ID: I20150306002159 |
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