| NPI | 1013195767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN L MARTIN Office Manager/ Fnp 901-476-7371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 34810) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 34955) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2023-03-07 |