| Primary Care Plus, Llc | |
|
1405 W Baddour Pkwy Suite 103 Lebanon TN 37087-2567 | |
| (615) 443-1579 | |
| (615) 443-1580 |
| Full Name | Primary Care Plus, Llc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 1405 W Baddour Pkwy, Lebanon, Tennessee |
| Authorized Official Name and Position | Venkatesh Madhav (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6154431579 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Plus, Llc 10211 Auburn Park Dr Fort Wayne IN 46825-2387 Ph: (260) 490-8187 | Primary Care Plus, Llc 1405 W Baddour Pkwy Suite 103 Lebanon TN 37087-2567 Ph: (615) 443-1579 |
| NPI Number | 1245465129 |
|---|---|
| Provider Enumeration Date | 05/21/2009 |
| Last Update Date | 12/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245465129 | NPI | - | NPPES |
| 1515562 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | L2436 (Texas) | Primary |
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