| Magnuson-stimpson Medical Clinic | |
|
1701 N Main St Suite D Shelbyville TN 37160-2303 | |
| (931) 685-4060 | |
| (931) 685-4062 |
| Full Name | Magnuson-stimpson Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1701 N Main St, Shelbyville, Tennessee |
| Authorized Official Name and Position | Carol L. Magnuson (GENERAL PARTNER) |
| Authorized Official Contact | 9316854060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnuson-stimpson Medical Clinic 1701 N Main St Suite D Shelbyville TN 37160-2303 Ph: (931) 685-4060 | Magnuson-stimpson Medical Clinic 1701 N Main St Suite D Shelbyville TN 37160-2303 Ph: (931) 685-4060 |
| NPI Number | 1346397064 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 06/01/2010 |
| Medicare PECOS PAC ID | 4385627066 |
|---|---|
| Medicare Enrollment ID | O20040611001462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346397064 | NPI | - | NPPES |
| 3719310 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD15929 (Tennessee) | Primary |
| 208000000X | Pediatrics | MD19528 (Tennessee) | Secondary |
| Provider Name | Charles L Stimpson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780654285 PECOS PAC ID: 2769465046 Enrollment ID: I20051210000056 |
| Provider Name | Pamela G Dehmlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962662858 PECOS PAC ID: 2567657992 Enrollment ID: I20101111000626 |
| Provider Name | Stevie Suzanne Pagello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144506635 PECOS PAC ID: 3577844950 Enrollment ID: I20161222001023 |
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Digestive Healthcare Of Middle Tennessee Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Airport Business Park Drive, Suite G, Shelbyville, TN 37160 Phone: 931-735-6036 Fax: 931-735-6293 | |
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