| NPI | 1255137212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL D GIBSON Credentialing Manager 615-988-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QU0200X Clinic/Center Urgent Care | |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-21 |