| Tennessee Primary Care, Llc | |
|
768 S Willow Ave Ste A Cookeville TN 38501-3892 | |
| (931) 559-6900 | |
| Not Available |
| Full Name | Tennessee Primary Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 768 S Willow Ave Ste A, Cookeville, Tennessee |
| Authorized Official Name and Position | Andrew D Johnson (OWNER) |
| Authorized Official Contact | 9314562728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tennessee Primary Care, Llc 15 Iris Ln Crossville TN 38555-7528 Ph: (931) 456-2728 | Tennessee Primary Care, Llc 768 S Willow Ave Ste A Cookeville TN 38501-3892 Ph: (931) 559-6900 |
| NPI Number | 1760251946 |
|---|---|
| Provider Enumeration Date | 12/28/2023 |
| Last Update Date | 01/03/2024 |
| Medicare PECOS PAC ID | 3870939051 |
|---|---|
| Medicare Enrollment ID | O20240311000942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760251946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Benjamin T. Aaron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811454077 PECOS PAC ID: 1052645991 Enrollment ID: I20190626000867 |
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