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General NPI Number Information
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NPI Number | 1497162382
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Entity Type | Organization
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Legal Business Name | SEASONS FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 07/13/2014
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 1611 S JEFFERSON AVE
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City | COOKEVILLE
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State | TN
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Zip | 38506-5566
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Country | US
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Telephone | 931-644-4664
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Fax | 833-992-2128
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Provider Business Mailing Address
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Address Line | 1611 S JEFFERSON AVE
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City | COOKEVILLE
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State | TN
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Zip | 38506-5566
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Country | US
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Telephone | 931-644-0262
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Fax | 833-992-2128
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PAMELA J SANDERS
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Credential | MD
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Telephone | 931-644-4664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 40043
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License Number State | TN
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