Doctors Office Llc | |
1430 Baddour Parkway Suite A Lebanon TN 37087-2514 | |
(615) 453-3645 | |
(615) 453-2675 |
Full Name | Doctors Office Llc |
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Speciality | Clinic/Center |
Location | 1430 Baddour Parkway, Lebanon, Tennessee |
Authorized Official Name and Position | Sheena H. Sloan (ADMINISTRATOR) |
Authorized Official Contact | 6154430436 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Doctors Office Llc 1430 Baddour Parkway Suite A Lebanon TN 37087-2514 Ph: (615) 453-3645 | Doctors Office Llc 1430 Baddour Parkway Suite A Lebanon TN 37087-2514 Ph: (615) 453-3645 |
NPI Number | 1578535936 |
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Provider Enumeration Date | 02/01/2006 |
Last Update Date | 12/19/2008 |
Medicare PECOS PAC ID | 6608930649 |
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Medicare Enrollment ID | O20090205000476 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578535936 | NPI | - | NPPES |
3381171 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
Provider Name | Wayne O Wells |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780685743 PECOS PAC ID: 9032273073 Enrollment ID: I20100209000646 |
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Concord Infectious Disease Associates, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1419 W Baddour Pkwy, Lebanon, TN 37087 Phone: 615-420-5390 Fax: 615-549-1532 | |
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