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General NPI Number Information
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NPI Number | 1457346702
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Entity Type | Organization
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Legal Business Name | DUE WEST FAMILY HEALTHCARE INC
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 607 W DUE WEST AVE STE 102
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City | MADISON
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State | TN
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Zip | 37115-4420
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Country | US
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Telephone | 615-868-2229
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Fax | 931-393-2247
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Provider Business Mailing Address
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Address Line | 607 W DUE WEST AVE STE 102
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City | MADISON
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State | TN
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Zip | 37115-4420
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Country | US
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Telephone | 615-868-2229
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Fax | 931-393-2432
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | PAT YORK
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Credential |
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Telephone | 615-868-2229
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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 | MD20429
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License Number State | TN
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