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2230 Cowan Hwy Ste B Winchester TN 37398-2627 | |
(931) 962-1345 | |
(931) 967-6439 |
Full Name | |
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Speciality | Family Medicine |
Location | 2230 Cowan Hwy Ste B, Winchester, Tennessee |
Authorized Official Name and Position | Stephen Scott Sommerschield (PRESIDENT) |
Authorized Official Contact | 9319621345 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 129 Winchester TN 37398-0129 Ph: (931) 962-1345 | 2230 Cowan Hwy Ste B Winchester TN 37398-2627 Ph: (931) 962-1345 |
NPI Number | 1104920685 |
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Provider Enumeration Date | 09/12/2006 |
Last Update Date | 08/07/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104920685 | NPI | - | NPPES |
3333230 | Medicaid | TN | |
1013941319 | Other | TN | NPI FOR INDIVIDUAL PROV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 39996 (Tennessee) | Primary |