| State Of Tennessee | |
|
1021 Spring St Dover TN 37058-3302 | |
| (931) 232-5329 | |
| (931) 232-7247 |
| Full Name | State Of Tennessee |
|---|---|
| Speciality | Public Health or Welfare |
| Location | 1021 Spring St, Dover, Tennessee |
| Authorized Official Name and Position | Annette M. Haley (REGIONAL DIRECTOR) |
| Authorized Official Contact | 6156507000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Tennessee 1021 Spring St Dover TN 37058-3302 Ph: (931) 232-5329 | State Of Tennessee 1021 Spring St Dover TN 37058-3302 Ph: (931) 232-5329 |
| NPI Number | 1083767883 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/28/2012 |
| Medicare PECOS PAC ID | 5698687077 |
|---|---|
| Medicare Enrollment ID | O20040402001142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083767883 | NPI | - | NPPES |
| 4448019 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Tennessee) | Secondary |
| 251K00000X | Public Health Or Welfare | (Tennessee) | Primary |
Allison Medical, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 Spring St, Dover, TN 37058 Phone: 931-232-5555 | |
Blane Clinical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1307 Donelson Pkwy, Dover, TN 37058 Phone: 931-232-0123 Fax: 931-232-1185 | |
Clarksville Physician Services Gp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 133 Dr Robert H Lee Drive, Dover, TN 37058 Phone: 888-304-1079 Fax: 615-469-6629 |