Healthcare Provider Details
I. General information
NPI: 1336357912
Provider Name (Legal Business Name): ARMADILLO MEDICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
420 COLLEGE ST STE A
LAFAYETTE TN
37083-1751
US
IV. Provider business mailing address
420 COLLEGE ST STE A
LAFAYETTE TN
37083-1751
US
V. Phone/Fax
- Phone: 615-688-5383
- Fax: 888-972-5790
- Phone: 615-688-5383
- Fax: 888-972-5790
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | MD000025613 |
| License Number State | TN |
VIII. Authorized Official
Name: DR.
PHILIP
W
HUNT
Title or Position: PRESIDENT / PRACTICE ADMINISTRATOR
Credential: MD
Phone: 615-688-5383