| Sarah Moon Thelen Md Pllc | |
|
305 College St W Fayetteville TN 37334-2911 | |
| (931) 227-4984 | |
| (931) 227-4985 |
| Full Name | Sarah Moon Thelen Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 305 College St W, Fayetteville, Tennessee |
| Authorized Official Name and Position | Sarah Moon Thelen (PHYSICIAN) |
| Authorized Official Contact | 9312274984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sarah Moon Thelen Md Pllc 2330 Thornton Taylor Pkwy Suite B Fayetteville TN 37334-3672 Ph: (931) 227-4984 | Sarah Moon Thelen Md Pllc 305 College St W Fayetteville TN 37334-2911 Ph: (931) 227-4984 |
| NPI Number | 1689971525 |
|---|---|
| Provider Enumeration Date | 02/11/2011 |
| Last Update Date | 02/28/2023 |
| Medicare PECOS PAC ID | 5698959880 |
|---|---|
| Medicare Enrollment ID | O20110413000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689971525 | NPI | - | NPPES |
| 1522804 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sallyann G Storer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457329302 PECOS PAC ID: 7012032048 Enrollment ID: I20100915000177 |
| Provider Name | Sarah M Thelen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952573289 PECOS PAC ID: 2769524974 Enrollment ID: I20110413000375 |
| Provider Name | Jenny Jean Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740937325 PECOS PAC ID: 3476932344 Enrollment ID: I20220623000909 |
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