| NPI | 1679962641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN TIDMORE Family Practice 931-967-7716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO 0000000400) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000015232) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |