Healthcare Provider Details

I. General information

NPI: 1326118837
Provider Name (Legal Business Name): TANGLEWOOD MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 DIXON SPRINGS HWY
CARTHAGE TN
37030-2161
US

IV. Provider business mailing address

259 DIXON SPRINGS HWY
CARTHAGE TN
37030-2161
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-3555
  • Fax: 615-735-3588
Mailing address:
  • Phone: 615-735-3555
  • Fax: 615-735-3588

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: MRS. LOUISE MARIE-THERESE VANDEWIELE
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 615-735-3555