McKenzie Medical Center PC
Clinic/Center, Rural Health in Mc Kenzie, TN. Organization (NPI-2).
NPI number1477516953
StatusActive
Last updated in NPPESDec 3, 2024
Details
- NPI
- 1477516953
- Entity type
- Organization (NPI-2)
- Legal business name
- McKenzie Medical Center PC
- Organization subpart
- No
- Enumeration date
- Apr 7, 2006
- Certification date
- Dec 3, 2024
- Last updated
- Dec 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | LSW5620 | TN | |
| 106H00000X | Marriage & Family Therapist | LMFT917 | TN | |
| 152W00000X | Optometrist | ODT441 | TN | |
| 207R00000X | Internal Medicine | MD15682 | TN | |
| 208000000X | Pediatrics | MD46412 | TN | |
| 363A00000X | Physician Assistant | PA1503 | TN | |
| 363LF0000X | Nurse Practitioner, Family | APN6244 | TN | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Other names
- Hometown Health Clinic (Doing Business As)
Practice location
205a Hospital DrMc Kenzie, TN 38201-1649
Phone 731-352-7907 · Fax 833-690-3848
Mailing address
205a Hospital DrMc Kenzie, TN 38201-1649
Phone 731-352-7907 · Fax 833-690-3848
Authorized official
Tammy Etheridge
Chief Operating Officer
7313527907
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