Healthcare Provider Details

I. General information

NPI: 1447092101
Provider Name (Legal Business Name): FAST PACE MEDICAL CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S BROAD ST
NEW TAZEWELL TN
37825-7239
US

IV. Provider business mailing address

6550 CAROTHERS PKWY STE 225
FRANKLIN TN
37067-6662
US

V. Phone/Fax

Practice location:
  • Phone: 423-919-8244
  • Fax:
Mailing address:
  • Phone: 615-364-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA HARLAN
Title or Position: DIRECTOR
Credential:
Phone: 615-948-9639