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General NPI Number Information
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NPI Number | 1437554540
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Entity Type | Organization
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Legal Business Name | ON TARGET MEDICAL CLINIC INC
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 490 SAINT ANDREWS DR STE 106
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City | MURFREESBORO
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State | TN
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Zip | 37128-6578
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Country | US
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Telephone | 615-962-7800
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Fax | 615-962-7879
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Provider Business Mailing Address
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Address Line | 490 SAINT ANDREWS DR STE 106
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City | MURFREESBORO
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State | TN
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Zip | 37128-6578
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Country | US
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Telephone | 615-962-7800
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Fax | 615-962-7879
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT DUNIGAN
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Credential |
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Telephone | 615-962-7800
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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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