| Mid South Med, Llc | |
|
9160 Highway 64 Suite 5 Lakeland TN 38002-4766 | |
| (901) 623-3587 | |
| (901) 213-9235 |
| Full Name | Mid South Med, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9160 Highway 64, Lakeland, Tennessee |
| Authorized Official Name and Position | Oliver Banks (OFFICE MANAGER) |
| Authorized Official Contact | 9014971040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid South Med, Llc 9160 Highway 64 Suite 5 Lakeland TN 38002-4766 Ph: (901) 623-3587 | Mid South Med, Llc 9160 Highway 64 Suite 5 Lakeland TN 38002-4766 Ph: (901) 623-3587 |
| NPI Number | 1356893226 |
|---|---|
| Provider Enumeration Date | 10/26/2016 |
| Last Update Date | 10/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356893226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD0000006816 (Tennessee) | Primary |
Makarios Group 3 Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9160 Us Highway 64 Ste 105, Lakeland, TN 38002 Phone: 901-213-0100 Fax: 901-213-0101 | |
Makarios Group 5, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8950 Us Highway 64, Suite 109, Lakeland, TN 38002 Phone: 901-213-0100 Fax: 901-213-0101 |