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General NPI Number Information
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NPI Number | 1639709561
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Entity Type | Organization
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Legal Business Name | AMERICAN MEDICAL PC
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Dates
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Enumeration Date | 01/20/2020
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 45 W 34TH ST RM 901
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City | NEW YORK
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State | NY
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Zip | 10001-3145
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Country | US
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Telephone | 212-239-8044
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Fax |
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Provider Business Mailing Address
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Address Line | 163 POPLAR CREEK RD
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City | DUNLAP
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State | TN
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Zip | 37327-6767
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Country | US
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Telephone | 615-562-4048
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOAN B SIMPSON
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Credential |
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Telephone | 615-562-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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