| Faith Healthcenter | |
|
655 Lexington Ave Jackson TN 38301-5075 | |
| (731) 215-2500 | |
| (731) 215-2500 |
| Full Name | Faith Healthcenter |
|---|---|
| Speciality | Family Medicine |
| Location | 655 Lexington Ave, Jackson, Tennessee |
| Authorized Official Name and Position | David M Larsen (DIRECTOR) |
| Authorized Official Contact | 7312152500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Healthcenter 655 Lexington Avenue Jackson TN 38301 Ph: (731) 215-2500 | Faith Healthcenter 655 Lexington Ave Jackson TN 38301-5075 Ph: (731) 215-2500 |
| NPI Number | 1740594217 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740594217 | NPI | - | NPPES |
| 3189311 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9731 (Tennessee) | Primary |
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