| Madison Family Practice | |
|
621 Old Hickory Blvd Suite G Jackson TN 38305-2907 | |
| (731) 660-6402 | |
| (731) 660-6402 |
| Full Name | Madison Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 621 Old Hickory Blvd, Jackson, Tennessee |
| Authorized Official Name and Position | Heather N Mcfarland (OWNER) |
| Authorized Official Contact | 7316606402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Family Practice 621 Old Hickory Blvd Suite G Jackson TN 38305-2907 Ph: (731) 660-6402 | Madison Family Practice 621 Old Hickory Blvd Suite G Jackson TN 38305-2907 Ph: (731) 660-6402 |
| NPI Number | 1407086101 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 04/24/2023 |
| Medicare PECOS PAC ID | 5991829228 |
|---|---|
| Medicare Enrollment ID | O20100824000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407086101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Heather N Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811028475 PECOS PAC ID: 0547336695 Enrollment ID: I20080915000082 |
| Provider Name | Corey A Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245537752 PECOS PAC ID: 3577731793 Enrollment ID: I20110714000052 |
| Provider Name | Ashley N Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063871507 PECOS PAC ID: 1052617628 Enrollment ID: I20160308000712 |
| Provider Name | Sara Elizabeth Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982210282 PECOS PAC ID: 6800291170 Enrollment ID: I20210825000433 |
| Provider Name | Chasity M Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982210241 PECOS PAC ID: 1355731563 Enrollment ID: I20211202000939 |
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