Dekalb Medical Clinic Llp | |
518 W Main St Ste C Smithville TN 37166-1100 | |
(615) 597-4005 | |
(615) 597-6667 |
Full Name | Dekalb Medical Clinic Llp |
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Speciality | Family Medicine |
Location | 518 W Main St Ste C, Smithville, Tennessee |
Authorized Official Name and Position | Tonya R Jennings (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6156842157 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dekalb Medical Clinic Llp 518 W Main St Ste C Smithville TN 37166-1100 Ph: (615) 597-4005 | Dekalb Medical Clinic Llp 518 W Main St Ste C Smithville TN 37166-1100 Ph: (615) 597-4005 |
NPI Number | 1700552890 |
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Provider Enumeration Date | 08/18/2021 |
Last Update Date | 08/18/2021 |
Medicare PECOS PAC ID | 9133527245 |
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Medicare Enrollment ID | O20211004002483 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700552890 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Tonya Renee Jennings |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255654083 PECOS PAC ID: 2466760681 Enrollment ID: I20151007001968 |
Provider Name | Johnny D Ball |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902532930 PECOS PAC ID: 5597163600 Enrollment ID: I20220823003082 |
Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 302 N Congress Blvd, Smithville, TN 37166 Phone: 615-597-4395 Fax: 615-597-5075 | |
Center Hill Medical, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 516 W Main St Ste C, Smithville, TN 37166 Phone: 615-597-4049 Fax: 615-597-4068 |