| Madison Street Family Clinic | |
|
1401 Madison St Suite A Shelbyville TN 37160-3629 | |
| (931) 685-2022 | |
| Not Available |
| Full Name | Madison Street Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1401 Madison St, Shelbyville, Tennessee |
| Authorized Official Name and Position | Rodney Parsons (OWNER) |
| Authorized Official Contact | 9316852022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Street Family Clinic 1401 Madison St Suite A Shelbyville TN 37160-3629 Ph: (931) 685-2022 | Madison Street Family Clinic 1401 Madison St Suite A Shelbyville TN 37160-3629 Ph: (931) 685-2022 |
| NPI Number | 1518238740 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 02/03/2012 |
| Medicare PECOS PAC ID | 7719140011 |
|---|---|
| Medicare Enrollment ID | O20120711000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518238740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 29483 (Tennessee) | Primary |
| Provider Name | Karyn E Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336247626 PECOS PAC ID: 9537214952 Enrollment ID: I20090908000249 |
| Provider Name | Lisa Smallwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801060835 PECOS PAC ID: 3870787476 Enrollment ID: I20110316000723 |
| Provider Name | Jennifer J Feldhaus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033353487 PECOS PAC ID: 9537305354 Enrollment ID: I20131004000382 |
| Provider Name | Tiffany N Coggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972932200 PECOS PAC ID: 5395974737 Enrollment ID: I20170929000345 |
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