Healthcare Provider Details

I. General information

NPI: 1043707896
Provider Name (Legal Business Name): MEDICAL ARTS HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOSPITAL CIR STE 103
PARIS TN
38242-4597
US

IV. Provider business mailing address

PO BOX 1030
PARIS TN
38242-1030
US

V. Phone/Fax

Practice location:
  • Phone: 731-644-8225
  • Fax:
Mailing address:
  • Phone: 731-644-8479
  • Fax: 731-644-8925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: THOMAS GEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 731-644-8479