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General NPI Number Information
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NPI Number | 1124116454
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Entity Type | Organization
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Legal Business Name | MCEWEN FAMILY CLINIC PLLC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 9307 HWY 70 EAST
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City | MCEWEN
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State | TN
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Zip | 37101
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Country | US
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Telephone | 931-582-6681
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Fax | 931-582-3758
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | MC EWEN
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State | TN
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Zip | 37101-0306
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Country | US
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Telephone | 931-582-6681
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Fax | 931-582-3758
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Authorized Official
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Title or Position | OWNER
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Name | DAVID WARREN YANCEY
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Credential | APN
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Telephone | 931-582-6681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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