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General NPI Number Information
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NPI Number | 1104920685
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Entity Type | Organization
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Legal Business Name | COWAN FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 2230 COWAN HWY STE B
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City | WINCHESTER
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State | TN
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Zip | 37398-2627
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Country | US
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Telephone | 931-962-1345
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Fax | 931-967-6439
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | WINCHESTER
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State | TN
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Zip | 37398-0129
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Country | US
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Telephone | 931-962-1345
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Fax | 931-967-6439
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN SCOTT SOMMERSCHIELD
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Credential | MD
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Telephone | 931-962-1345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39996
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License Number State | TN
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