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General NPI Number Information
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NPI Number | 1639482292
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Entity Type | Organization
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Legal Business Name | CENTERS FOR FAMILY MEDICINE, PC
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 07/23/2010
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Provider Practice Location Address
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Address Line | 5114 OLD HICKORY BLVD SUITE 201
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City | HERMITAGE
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State | TN
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Zip | 37076-2589
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Country | US
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Telephone | 615-889-6080
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Fax | 615-884-0370
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Provider Business Mailing Address
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Address Line | 5114 OLD HICKORY BLVD SUITE 201
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City | HERMITAGE
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State | TN
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Zip | 37076-2589
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Country | US
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Telephone | 615-889-6080
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Fax | 615-884-0370
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. JOYCE A HILT
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Credential |
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Telephone | 615-889-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM230
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BM7363447
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License Number State | TN
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