| Optimum Medical Group | |
|
10044 Highway 46 Bon Aqua TN 37025-1764 | |
| (931) 996-4247 | |
| Not Available |
| Full Name | Optimum Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 10044 Highway 46, Bon Aqua, Tennessee |
| Authorized Official Name and Position | Christopher Shea Burress (OWNER) |
| Authorized Official Contact | 6159964247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Medical Group 10044 Highway 46 Bon Aqua TN 37025-1764 | Optimum Medical Group 10044 Highway 46 Bon Aqua TN 37025-1764 Ph: (931) 996-4247 |
| NPI Number | 1568925329 |
|---|---|
| Provider Enumeration Date | 04/09/2019 |
| Last Update Date | 06/08/2025 |
| Certification Date | 06/08/2025 |
| Medicare PECOS PAC ID | 2961735097 |
|---|---|
| Medicare Enrollment ID | O20190605001012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568925329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Secondary |
| 207R00000X | Internal Medicine | (NU) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| Provider Name | Christopher S Burress |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073603411 PECOS PAC ID: 0840396891 Enrollment ID: I20090709000758 |
D/b/a Optimum Internal Medicine and Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10044 Highway 46, Bon Aqua, TN 37025 Phone: 931-996-4247 Fax: 931-996-4248 |