Healthcare Provider Details

I. General information

NPI: 1265051577
Provider Name (Legal Business Name): MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S CROSS BRIDGES RD
MT PLEASANT TN
38474-1714
US

IV. Provider business mailing address

PO BOX 100054
ATLANTA GA
30348-0054
US

V. Phone/Fax

Practice location:
  • Phone: 931-379-5821
  • Fax: 931-379-5867
Mailing address:
  • Phone: 931-379-5821
  • Fax: 931-379-5867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GREGORY A WHITLOCK
Title or Position: VP FINANCE/IT
Credential:
Phone: 931-540-4212