Covenant Medical Fairview, PC
Family Medicine in Fairview, TN. Organization (NPI-2).
NPI number1164099339
StatusActive
Last updated in NPPESJun 7, 2021
Details
- NPI
- 1164099339
- Entity type
- Organization (NPI-2)
- Legal business name
- Covenant Medical Fairview, PC
- Organization subpart
- No
- Enumeration date
- Jun 7, 2021
- Certification date
- Jun 7, 2021
- Last updated
- Jun 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
2340 Fairview Blvd Ste 600dFairview, TN 37062-9457
Phone 615-266-2177
Mailing address
2340 Fairview Blvd Ste 600dFairview, TN 37062-9457
Phone 615-266-2177
Authorized official
Kelley R Carpenter
Practice Administrator
6152188566
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