Healthcare Provider Details

I. General information

NPI: 1063495083
Provider Name (Legal Business Name): CARTHAGE FAMILY HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 HOSPITAL DR SUITE 200
CARTHAGE TN
37030-4004
US

IV. Provider business mailing address

133 HOSPITAL DR SUITE 200
CARTHAGE TN
37030-4004
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-3450
  • Fax: 615-735-3460
Mailing address:
  • Phone: 615-735-3450
  • Fax: 615-735-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27451
License Number StateTN

VIII. Authorized Official

Name: MR. CHRISTOPHER T LEWIS
Title or Position: PRESIDENT
Credential: ACNP
Phone: 615-735-3450