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, Psych/Mental Health | |
Enumeration Date | 2020-03-30 |
Last Update Date | 2024-05-03 |