| NPI | 1578848693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK D HYDRICK Provider/Owner 615-895-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 34250) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 208D00000X General Practice | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 7765) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN APN15544) | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2013-04-24 |