| Family Clinic At The Lake Pllc | |
|
1440 Pickwick St Savannah TN 38372-3519 | |
| (731) 925-3354 | |
| (731) 438-3581 |
| Full Name | Family Clinic At The Lake Pllc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1440 Pickwick St, Savannah, Tennessee |
| Authorized Official Name and Position | Ellanikole Jackson (OWNER) |
| Authorized Official Contact | 9015008629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Clinic At The Lake Pllc Po Box 55 Savannah TN 38372-0055 Ph: (731) 925-3354 | Family Clinic At The Lake Pllc 1440 Pickwick St Savannah TN 38372-3519 Ph: (731) 925-3354 |
| NPI Number | 1295620557 |
|---|---|
| Provider Enumeration Date | 06/09/2025 |
| Last Update Date | 06/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295620557 | NPI | - | NPPES |
| 44D2112604 | Other | TN | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Hardin County Regional Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 Davis St, Savannah, TN 38372 Phone: 731-925-8879 | |
Hardin County Regional Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 East End Drive, Savannah, TN 38372 Phone: 731-925-2300 Fax: 731-926-1373 | |
Hardin County Regional Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 175 Enoch Blvd, Savannah, TN 38372 Phone: 731-925-2300 | |
Hardin County Regional Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 765 Florence Rd, Savannah, TN 38372 Phone: 731-925-2300 Fax: 731-925-2157 | |
Hardin County Board Of Education Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Guinn St, Savannah, TN 38372 Phone: 731-925-3943 Fax: 731-925-3943 | |
Hmc Physician Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 935 Wayne Road, Savannah, TN 38372 Phone: 731-925-9909 Fax: 731-925-3323 |