| Fayetteville Medical Associates, Pc | |
|
207 Elk Ave S Fayetteville TN 37334-3051 | |
| (931) 433-2551 | |
| (931) 438-0069 |
| Full Name | Fayetteville Medical Associates, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 207 Elk Ave S, Fayetteville, Tennessee |
| Authorized Official Name and Position | Susan Hudson (ADMINISTRATOR) |
| Authorized Official Contact | 9314381676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayetteville Medical Associates, Pc 207 Elk Ave S Fayetteville TN 37334-3051 Ph: (931) 433-2551 | Fayetteville Medical Associates, Pc 207 Elk Ave S Fayetteville TN 37334-3051 Ph: (931) 433-2551 |
| NPI Number | 1902873953 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902873953 | NPI | - | NPPES |
| 3703791 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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