Healthcare Provider Details

I. General information

NPI: 1154348837
Provider Name (Legal Business Name): RHEA CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17310 HWY 64
SOMERVILLE TN
38068
US

IV. Provider business mailing address

17310 HWY 64
SOMERVILLE TN
38068
US

V. Phone/Fax

Practice location:
  • Phone: 901-465-2245
  • Fax: 901-465-8683
Mailing address:
  • Phone: 901-465-2245
  • Fax: 901-465-8683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000018090
License Number StateTN

VIII. Authorized Official

Name: DR. KARL B RHEA JR.
Title or Position: MD
Credential: MD
Phone: 901-465-2245