| Shelbyville Medical Group, Pllc | |
|
221 Lane Parkway Shelbyville TN 37160 | |
| (931) 685-1145 | |
| (931) 685-8014 |
| Full Name | Shelbyville Medical Group, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 221 Lane Parkway, Shelbyville, Tennessee |
| Authorized Official Name and Position | Joseph H. Rupard (OWNER) |
| Authorized Official Contact | 9316851145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelbyville Medical Group, Pllc P.o. Box 1279 Shelbyville TN 37162-2607 Ph: (931) 685-1145 | Shelbyville Medical Group, Pllc 221 Lane Parkway Shelbyville TN 37160 Ph: (931) 685-1145 |
| NPI Number | 1699177956 |
|---|---|
| Provider Enumeration Date | 09/18/2014 |
| Last Update Date | 05/16/2016 |
| Medicare PECOS PAC ID | 0446555866 |
|---|---|
| Medicare Enrollment ID | O20160223002316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699177956 | NPI | - | NPPES |
| Q0195517 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD024783 (Tennessee) | Primary |
| Provider Name | Joseph Howard Rupard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861451338 PECOS PAC ID: 7214052356 Enrollment ID: I20100914000285 |
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