Healthcare Provider Details

I. General information

NPI: 1699168195
Provider Name (Legal Business Name): HARTON CLINIC COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 N JACKSON ST BLDG A SUITE 100
TULLAHOMA TN
37388-2290
US

IV. Provider business mailing address

PO BOX 689022
FRANKLIN TN
37068-9022
US

V. Phone/Fax

Practice location:
  • Phone: 931-393-7831
  • Fax: 931-393-7833
Mailing address:
  • Phone: 615-465-7587
  • Fax: 615-628-6877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES P WRIGHT
Title or Position: DIRECTOR
Credential:
Phone: 615-465-7587