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NPI Code Detail

MEDICARE: SPRING CITY FAMILY CLINIC PLLC

MEDICARE: SPRING CITY FAMILY CLINIC PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1023631454
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING CITY FAMILY CLINIC PLLC
Provider Business Mailing Address
First Line : PO BOX 710
Second Line :
City : SPRING CITY
State : TN
Zip : 37381-0710
Country : US
Telephone Number : 423-452-9984
Fax Number : 423-452-9980
Provider Business Practice Location Address
First Line : 126 LAVENDER ST STE 2
Second Line :
City : SPRING CITY
State : TN
Zip : 37381-5102
Country : US
Telephone Number : 423-452-9984
Fax Number : 423-452-9980
Authorized Official
Title or Position : OWNER
Name : JOY GIBSON
Credential :
Telephone Number : 423-452-9984
Provider Enumeration Date : 05/20/2020
Last Update Date : 02/12/2024

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Directions to “SPRING CITY FAMILY CLINIC PLLC ” Practice Location

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