Healthcare Provider Details

I. General information

NPI: 1215751409
Provider Name (Legal Business Name): GENTLE HEARTS FAMILY CLINIC AND URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 VETERANS PKWY STE F
MURFREESBORO TN
37128-6432
US

IV. Provider business mailing address

435 TITANS CIR
MURFREESBORO TN
37127-7166
US

V. Phone/Fax

Practice location:
  • Phone: 615-801-7590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MUHAMED FAOUR
Title or Position: MD
Credential: MD
Phone: 615-801-7590