Healthcare Provider Details

I. General information

NPI: 1528185428
Provider Name (Legal Business Name): ERIN FAMILY MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4895 EAST MAIN ST SUITE C
ERIN TN
37061
US

IV. Provider business mailing address

PO BOX 288
ERIN TN
37061-0288
US

V. Phone/Fax

Practice location:
  • Phone: 931-289-2450
  • Fax: 931-289-2453
Mailing address:
  • Phone: 931-289-2450
  • Fax: 931-289-2453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1387
License Number StateTN

VIII. Authorized Official

Name: DR. PHILLIP SHAWN HOLMES
Title or Position: OWNER
Credential: D.O.
Phone: 931-289-2450