| Mid-tennesse Medical | |
|
110 Weakley Creek Rd Lawrenceburg TN 38464-2238 | |
| (931) 766-5001 | |
| (931) 762-3800 |
| Full Name | Mid-tennesse Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 110 Weakley Creek Rd, Lawrenceburg, Tennessee |
| Authorized Official Name and Position | Kellie Coffey (OWNER) |
| Authorized Official Contact | 9317665001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-tennesse Medical 110 Weakley Creek Rd Lawrenceburg TN 38464-2238 Ph: (931) 766-5001 | Mid-tennesse Medical 110 Weakley Creek Rd Lawrenceburg TN 38464-2238 Ph: (931) 766-5001 |
| NPI Number | 1750456414 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 03/10/2014 |
| Medicare PECOS PAC ID | 0345467643 |
|---|---|
| Medicare Enrollment ID | O20140811001024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750456414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Richard D Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215029897 PECOS PAC ID: 3476545195 Enrollment ID: I20040401001272 |
| Provider Name | Kellie D Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063637270 PECOS PAC ID: 5294829537 Enrollment ID: I20070918000474 |
| Provider Name | Shonda Danielle Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033556352 PECOS PAC ID: 0648404426 Enrollment ID: I20131010000149 |
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