MEDICARE: CMC PHYSICIAN GROUP

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
1	207R00000X	Internal Medicine Physician	35554	TN

General Provider Information

NPI Number	:	1063553824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CMC PHYSICIAN GROUP

Provider Business Mailing Address
First Line	:	47 CROSS CREEK PL APT ART.11
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-5082
Country	:	US
Telephone Number	:	931-707-8162
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 HAYES ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-8000
Country	:	US
Telephone Number	:	931-456-9434
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ANGEL SUZANNE TURNER
Credential	:	MD
Telephone Number	:	931-261-2556

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

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Directions to “CMC PHYSICIAN GROUP ” Practice Location

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