Healthcare Provider Details

I. General information

NPI: 1487788501
Provider Name (Legal Business Name): FAMILY CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 PARR AVE STE D
DYERSBURG TN
38024-2074
US

IV. Provider business mailing address

PO BOX 688 1716 PARR AVENUE, SUITE D
DYERSBURG TN
38025-0688
US

V. Phone/Fax

Practice location:
  • Phone: 731-288-0911
  • Fax: 731-288-0065
Mailing address:
  • Phone: 731-288-0911
  • Fax: 731-288-0065

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: DOREEN FELDHOUSE
Title or Position: PRESIDENT
Credential: MD
Phone: 731-288-0911