Healthcare Provider Details

I. General information

NPI: 1265706550
Provider Name (Legal Business Name): TUNNEL HILL WALK IN MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2012
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3541 CHATTANOOGA RD
TUNNEL HILL GA
30755-9393
US

IV. Provider business mailing address

PO BOX 1117
TUNNEL HILL GA
30755-1117
US

V. Phone/Fax

Practice location:
  • Phone: 706-516-4426
  • Fax: 706-516-4429
Mailing address:
  • Phone: 706-516-4426
  • Fax: 706-516-4429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JIM B YOUNG
Title or Position: OWNER
Credential:
Phone: 706-516-4426