Healthcare Provider Details

I. General information

NPI: 1750399085
Provider Name (Legal Business Name): SPRING CITY FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NEW LAKE RD SUITE 100
SPRING CITY TN
37381-5460
US

IV. Provider business mailing address

800 NEW LAKE RD SUITE 100
SPRING CITY TN
37381-5460
US

V. Phone/Fax

Practice location:
  • Phone: 423-365-9000
  • Fax: 423-365-9077
Mailing address:
  • Phone: 423-365-9000
  • Fax: 423-365-9077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO0000001536
License Number StateTN

VIII. Authorized Official

Name: DR. WILLIAM THURMAN BATES III
Title or Position: CHIEF OFFICER
Credential: D.O.
Phone: 423-365-9000