| Physician Management Services Of Tennessee, Llc | |
|
457 Vista Dr Sparta TN 38583-1360 | |
| (888) 829-8550 | |
| Not Available |
| Full Name | Physician Management Services Of Tennessee, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 457 Vista Dr, Sparta, Tennessee |
| Authorized Official Name and Position | Brett Kenefick (PRESIDENT) |
| Authorized Official Contact | 8888298550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Management Services Of Tennessee, Llc 3113 Lawton Rd Ste 250 Orlando FL 32803-3517 Ph: (888) 829-8550 | Physician Management Services Of Tennessee, Llc 457 Vista Dr Sparta TN 38583-1360 Ph: (888) 829-8550 |
| NPI Number | 1861054173 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 04/30/2021 |
| Medicare PECOS PAC ID | 0143558627 |
|---|---|
| Medicare Enrollment ID | O20190821003090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861054173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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