Healthcare Provider Details

I. General information

NPI: 1821906173
Provider Name (Legal Business Name): PHYSICIANS QUALITY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15463 S FIRST ST
MILAN TN
38358-6475
US

IV. Provider business mailing address

PO BOX 12197
JACKSON TN
38308-0136
US

V. Phone/Fax

Practice location:
  • Phone: 731-686-8688
  • Fax:
Mailing address:
  • Phone: 731-984-8400
  • Fax: 731-984-8305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRACEY GLISSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 731-984-8400