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General NPI Number Information
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NPI Number | 1245590371
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Entity Type | Organization
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Legal Business Name | CALEB CREEK HOSPITALISTS
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 100 NORTHCREST DR
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City | SPRINGFIELD
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State | TN
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Zip | 37172-3927
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Country | US
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Telephone | 205-313-3680
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31388
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City | CLARKSVILLE
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State | TN
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Zip | 37040-0024
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MARK GREEN
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Credential | MD
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Telephone | 931-249-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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