Healthcare Provider Details

I. General information

NPI: 1700712833
Provider Name (Legal Business Name): PUTNAM COUNTY PEDIATRICS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 S WILLOW AVE
COOKEVILLE TN
38501-3840
US

IV. Provider business mailing address

758 S WILLOW AVE
COOKEVILLE TN
38501-3840
US

V. Phone/Fax

Practice location:
  • Phone: 931-526-6173
  • Fax:
Mailing address:
  • Phone: 931-526-6173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPER D CLIMACO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 931-261-0207