| D/b/a Optimum Internal Medicine And Pediatrics | |
|
10044 Highway 46 Bon Aqua TN 37025-1764 | |
| (931) 996-4247 | |
| (931) 996-4248 |
| Full Name | D/b/a Optimum Internal Medicine And Pediatrics |
|---|---|
| Speciality | Internal Medicine |
| Location | 10044 Highway 46, Bon Aqua, Tennessee |
| Authorized Official Name and Position | Christopher S. Burress (OWNER) |
| Authorized Official Contact | 9319964247 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D/b/a Optimum Internal Medicine And Pediatrics 10044 Highway 46 Bon Aqua TN 37025-1764 Ph: (931) 996-4247 | D/b/a Optimum Internal Medicine And Pediatrics 10044 Highway 46 Bon Aqua TN 37025-1764 Ph: (931) 996-4247 |
| NPI Number | 1669873113 |
|---|---|
| Provider Enumeration Date | 09/15/2014 |
| Last Update Date | 02/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669873113 | NPI | - | NPPES |
| 1522546 | Medicaid | TN | |
| 11777708 | Other | TN | CAQH |
| 1073603411 | Other | AL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
Optimum Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10044 Highway 46, Bon Aqua, TN 37025 Phone: 931-996-4247 |