| Centennial Primary Care LLC | |
|
1009 N Locust Ave Suite 1 Lawrenceburg TN 38464-2706 | |
| (931) 762-0531 | |
| (931) 762-0998 |
| Full Name | Centennial Primary Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1009 N Locust Ave, Lawrenceburg, Tennessee |
| Authorized Official Name and Position | Gary Duncan (VICE PRESIDENT) |
| Authorized Official Contact | 9547675716 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centennial Primary Care LLC 1009 N Locust Ave Suite 1 Lawrenceburg TN 38464-2706 Ph: (931) 762-0531 | Centennial Primary Care LLC 1009 N Locust Ave Suite 1 Lawrenceburg TN 38464-2706 Ph: (931) 762-0531 |
| NPI Number | 1265617674 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 06/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265617674 | NPI | - | NPPES |
| 3370233 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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