Healthcare Provider Details

I. General information

NPI: 1053548487
Provider Name (Legal Business Name): ONE STOP MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 N LOCUST AVE
LAWRENCEBURG TN
38464-3516
US

IV. Provider business mailing address

PO BOX 191
LAWRENCEBURG TN
38464-0191
US

V. Phone/Fax

Practice location:
  • Phone: 931-762-9797
  • Fax: 931-762-9798
Mailing address:
  • Phone: 931-762-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUDY C LONG
Title or Position: BILLING MANAGER
Credential:
Phone: 931-424-9797