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General NPI Number Information
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NPI Number | 1902485014
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Entity Type | Organization
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Legal Business Name | FP INDIANA LLC
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 202 CARRIE LN
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City | COLUMBUS
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State | IN
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Zip | 47201-9228
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Country | US
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Telephone | 901-351-1791
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Fax |
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Provider Business Mailing Address
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Address Line | 6550 CAROTHERS PKWY
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City | FRANKLIN
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State | TN
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Zip | 37067-6693
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Country | US
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Telephone | 901-351-1791
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | SYDNI CLEMMONS
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Credential |
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Telephone | 901-351-1791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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