Healthcare Provider Details

I. General information

NPI: 1629136379
Provider Name (Legal Business Name): BEDFORD FAMILY PRACTICE URGENT CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 06/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 NORTH MAIN STREET SUITE A
SHELBYVILLE TN
37160-2610
US

IV. Provider business mailing address

1612 NORTH MAIN STREET SUITE A
SHELBYVILLE TN
37160-2610
US

V. Phone/Fax

Practice location:
  • Phone: 931-685-2022
  • Fax: 931-685-4158
Mailing address:
  • Phone: 931-685-2022
  • Fax: 931-685-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. LYNETTE ADAMS
Title or Position: DOCTOR
Credential: M.D.
Phone: 931-680-8910