| NPI | 1124656616 |
|---|---|
| Former Legal Business Name | MAIN STREET MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MELINDA HENDERSON Cmo 615-585-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-05-03 |