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General NPI Number Information
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NPI Number | 1871823989
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Entity Type | Organization
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Legal Business Name | AMERICAN MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 315 S WALNUT BEND RD CORDOVA
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City | CORDOVA
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State | TN
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Zip | 38018-7216
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Country | US
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Telephone | 901-219-6840
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Fax | 901-219-6740
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Provider Business Mailing Address
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Address Line | 315 S WALNUT BEND RD CORDOVA
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City | CORDOVA
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State | TN
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Zip | 38018-7216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. CAROL J. MCCOURT
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Credential | MD
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Telephone | 901-730-1229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 31930
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License Number State | TN
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