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General NPI Number Information
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NPI Number | 1467667592
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Entity Type | Organization
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Legal Business Name | PUTNAM COUNTY RURAL HEALTH CLINIC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 117 W COMMERCIAL AVE
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City | MONTEREY
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State | TN
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Zip | 38574-1107
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Country | US
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Telephone | 931-839-6695
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Fax | 931-858-3850
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Provider Business Mailing Address
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Address Line | 117 W COMMERCIAL AVE
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City | MONTEREY
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State | TN
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Zip | 38574-1107
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Country | US
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Telephone | 931-839-6695
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Fax | 931-858-3850
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENYA WILLIAMS
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Credential | MD
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Telephone | 931-839-6695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State |
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