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General NPI Number Information
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NPI Number | 1770103863
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Entity Type | Organization
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Legal Business Name | MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1222 TROTWOOD AVE STE 101
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City | COLUMBIA
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State | TN
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Zip | 38401-6404
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Country | US
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Telephone | 931-490-7372
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Fax | 931-490-7379
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Provider Business Mailing Address
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Address Line | PO BOX 100054
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City | ATLANTA
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State | GA
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Zip | 30348-0054
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Country | US
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Telephone | 931-490-1295
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Fax | 931-490-1298
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Authorized Official
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Title or Position | VP FINANCE/IT
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Name | GREGORY A WHITLOCK III
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Credential |
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Telephone | 931-540-4212
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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