Healthcare Provider Details
I. General information
NPI: 1962520783
Provider Name (Legal Business Name): FAMILY MEDICINE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 01/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7046 HIGHWAY 64
OAKLAND TN
38060-3208
US
IV. Provider business mailing address
7046 HIGHWAY 64
OAKLAND TN
38060-3208
US
V. Phone/Fax
- Phone: 901-465-9902
- Fax: 901-465-2110
- Phone: 901-465-9902
- Fax: 901-465-2110
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALICE
R
MCKEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 901-465-9902