Trenton Medical Clinic Pllc | |
120 Davy Crockett Mall Trenton TN 38382-2934 | |
(731) 855-3719 | |
Not Available |
Full Name | Trenton Medical Clinic Pllc |
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Speciality | Clinic/Center |
Location | 120 Davy Crockett Mall, Trenton, Tennessee |
Authorized Official Name and Position | Adenike Fatomoh Adedeji (NURSE PRACTITIONER) |
Authorized Official Contact | 7318553719 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Trenton Medical Clinic Pllc 120 Davy Crockett Mall Trenton TN 38382-2934 Ph: (731) 855-3719 | Trenton Medical Clinic Pllc 120 Davy Crockett Mall Trenton TN 38382-2934 Ph: (731) 855-3719 |
NPI Number | 1043750193 |
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Provider Enumeration Date | 03/07/2017 |
Last Update Date | 03/07/2017 |
Medicare PECOS PAC ID | 0042597569 |
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Medicare Enrollment ID | O20170509003040 |
Identifier | Type | State | Issuer |
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1043750193 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | APN18036 (Tennessee) | Primary |
Provider Name | Adenike Fatimoh Adedeji |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992134597 PECOS PAC ID: 4688777147 Enrollment ID: I20141104001194 |
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