| Covenant Family Practice | |
|
1000 Highway 76 Clarksville TN 37043-8405 | |
| (931) 245-1150 | |
| (931) 245-0605 |
| Full Name | Covenant Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1000 Highway 76, Clarksville, Tennessee |
| Authorized Official Name and Position | Robert Alan Wilson (PRESIDENT) |
| Authorized Official Contact | 6152451150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Family Practice Po Box 30594 Clarksville TN 37040-0010 Ph: (931) 245-1150 | Covenant Family Practice 1000 Highway 76 Clarksville TN 37043-8405 Ph: (931) 245-1150 |
| NPI Number | 1649574211 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 11/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649574211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 15390 (Tennessee) | Primary |
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