Healthcare Provider Details

I. General information

NPI: 1912736968
Provider Name (Legal Business Name): MURFREESBORO MEDICAL CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 SHORES RD
MURFREESBORO TN
37128-3616
US

IV. Provider business mailing address

3325 SHORES RD
MURFREESBORO TN
37128-3616
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-4480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH A PEAY
Title or Position: CEO
Credential:
Phone: 615-893-4480