Healthcare Provider Details

I. General information

NPI: 1538191135
Provider Name (Legal Business Name): MAIN STREET FAMILY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 US HIGHWAY 45 N
HENDERSON TN
38340-4003
US

IV. Provider business mailing address

1306 US HIGHWAY 45 N
HENDERSON TN
38340-4003
US

V. Phone/Fax

Practice location:
  • Phone: 731-989-9899
  • Fax: 731-989-3495
Mailing address:
  • Phone: 731-989-9899
  • Fax: 731-989-3495

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: PAUL EDWARD SCHWARTZ
Title or Position: OWNER
Credential: MD
Phone: 731-989-9899