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General NPI Number Information
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NPI Number | 1356528970
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Entity Type | Organization
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Legal Business Name | WEAKLEY COUNTY FAMILY MEDICINE, INC.
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 115 MOUNT PELIA RD
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City | MARTIN
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State | TN
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Zip | 38237-3315
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Country | US
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Telephone | 731-587-5353
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Fax | 731-588-0906
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Provider Business Mailing Address
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Address Line | PO BOX 1064
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City | MARTIN
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State | TN
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Zip | 38237-1064
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Country | US
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Telephone | 731-587-5353
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Fax | 731-588-0906
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Authorized Official
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Title or Position | OWNER, PHYSICIAN
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Name | DR. KENNETH W CARR
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Credential | M.D.
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Telephone | 731-587-5353
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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 |
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License Number State |
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