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2330 Thornton Taylor Pkwy Fayetteville TN 37334-3672 | |
| (931) 227-4984 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2330 Thornton Taylor Pkwy, Fayetteville, Tennessee |
| Authorized Official Name and Position | Dawn Casey (OFFICE MANAGER) |
| Authorized Official Contact | 9312274984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 38 Fayetteville TN 37334-0038 Ph: () - | 2330 Thornton Taylor Pkwy Fayetteville TN 37334-3672 Ph: (931) 227-4984 |
| NPI Number | 1861986499 |
|---|---|
| Provider Enumeration Date | 06/18/2018 |
| Last Update Date | 06/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861986499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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