Advance Care Medical Pcp Tennessee
Clinic/Center, Primary Care in Clarksville, TN. Organization (NPI-2).
NPI number1164094819
StatusActive
Last updated in NPPESMay 11, 2022
Details
- NPI
- 1164094819
- Entity type
- Organization (NPI-2)
- Legal business name
- Advance Care Medical Pcp Tennessee
- Organization subpart
- No
- Enumeration date
- Jul 13, 2021
- Certification date
- May 11, 2022
- Last updated
- May 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Other names
- Advance Care Medical Clarksville Tn (Doing Business As)
Practice location
1469 Tiny Town RdClarksville, TN 37042-7202
Phone 516-801-1552
Mailing address
3 School St Ste 303Glen Cove, NY 11542-2548
Phone 516-801-1552
Authorized official
Douglas Millar
Senior Advisor
9176736321
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