Organization · NPI-2

45 Urgent Care, P.C.

Family Medicine · Jackson, TN

NPI number1912326539
StatusActive
Last updated in NPPESMar 13, 2015

Details

NPI
1912326539
Entity type
Organization (NPI-2)
Legal business name
45 Urgent Care, P.C.
Organization subpart
No
Enumeration date
Apr 10, 2014
Last updated
Mar 13, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine34403TNYes

Practice location

149 N Star Dr
Jackson, TN 38305-5634

Phone 731-554-0571 · Fax 731-664-7161

Mailing address

2012 Greystone Sq
Jackson, TN 38305-3575

Phone 731-664-6998 · Fax 731-664-7161

Authorized official

Shannon L Bone
President
7316646998

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