| Dr George T Mathai Pllc | |
|
224 Long St New Johnsonville TN 37134-2468 | |
| (931) 535-3734 | |
| (931) 535-3742 |
| Full Name | Dr George T Mathai Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 224 Long St, New Johnsonville, Tennessee |
| Authorized Official Name and Position | George Thottakara Mathai (OWNER) |
| Authorized Official Contact | 9315353734 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr George T Mathai Pllc 224 Long St New Johnsonville TN 37134-2468 Ph: (931) 535-3734 | Dr George T Mathai Pllc 224 Long St New Johnsonville TN 37134-2468 Ph: (931) 535-3734 |
| NPI Number | 1558553727 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 05/28/2008 |
| Medicare PECOS PAC ID | 9234218678 |
|---|---|
| Medicare Enrollment ID | O20080509000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558553727 | NPI | - | NPPES |
| 3889576 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | George T Mathai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316098858 PECOS PAC ID: 9234024407 Enrollment ID: I20040217000537 |
| Provider Name | Brittni Burlison Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366107575 PECOS PAC ID: 1557757481 Enrollment ID: I20220401001251 |