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155 Hospital Rd Suite B Winchester TN 37398-2494 | |
(931) 962-4040 | |
(931) 962-2277 |
Full Name | |
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Speciality | General Practice |
Location | 155 Hospital Rd, Winchester, Tennessee |
Authorized Official Name and Position | William Gracey (COO) |
Authorized Official Contact | 6153728500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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155 Hospital Rd Suite B Winchester TN 37398-2494 Ph: (931) 962-4040 | 155 Hospital Rd Suite B Winchester TN 37398-2494 Ph: (931) 962-4040 |
NPI Number | 1154373512 |
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Provider Enumeration Date | 05/16/2006 |
Last Update Date | 06/17/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154373512 | NPI | - | NPPES |
3716446 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |