| Covenant Medical Group | |
|
200 Creekside Dr Dickson TN 37055-2176 | |
| (615) 851-6033 | |
| Not Available |
| Full Name | Covenant Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Creekside Dr, Dickson, Tennessee |
| Authorized Official Name and Position | Susan Fenton (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 6158516033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Medical Group 3024 Business Park Cir Goodlettsville TN 37072-3132 Ph: (615) 851-6033 | Covenant Medical Group 200 Creekside Dr Dickson TN 37055-2176 Ph: (615) 851-6033 |
| NPI Number | 1487121703 |
|---|---|
| Provider Enumeration Date | 10/24/2018 |
| Last Update Date | 10/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487121703 | NPI | - | NPPES |
| 3372986 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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