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Crockett Medical Clinic Inc

Crockett Medical Clinic Inc is a health care provider in Alamo, TN. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 58 S. Bells St, Alamo, TN 38001, US
Practice Location Phone731-696-5401
Practice Location Fax731-696-5404
Legal Business NameCROCKETT MEDICAL CLINIC INC
NPI ?1104839703
Entity TypeOrganization
Enumeration Date ? Aug 14, 2006
Last Update Date ? Feb 27, 2014
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Crockett Medical Clinic Inc

SpecialtySpecializationLicenseLicense State
Family Medicine
Nurse Practitioner

legacy-id-icon Legacy Provider IDs of Crockett Medical Clinic Inc

Provider IdIssuer StateIssuer TypeIssuer
3717707TennesseeMedicaid
3717707TennesseeOtherPTAN

official-icon Authorized Official of Crockett Medical Clinic Inc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Crockett Medical Clinic Inc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Charles Richard Jerman
Authorized Official Title/PositionCFO
Authorized Official Phone Number731-696-4670