MEDICARE: CAMDEN MEDICAL CLINIC, INC

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	261Q00000X	Clinic/Center	APN0000006407	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	44D0984486	OTHER		CLIA NUMBER

General Provider Information

NPI Number	:	1285612564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMDEN MEDICAL CLINIC, INC

Provider Business Mailing Address
First Line	:	160 HOSPITAL DR.
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320
Country	:	US
Telephone Number	:	731-279-0600
Fax Number	:	731-279-0555

Provider Business Practice Location Address
First Line	:	160 HOSPITAL DR.
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320
Country	:	US
Telephone Number	:	731-279-0600
Fax Number	:	731-279-0555

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MS. DEBORAH T WOOD
Credential	:	FNP
Telephone Number	:	731-279-0600

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	02/02/2011

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Directions to “CAMDEN MEDICAL CLINIC, INC ” Practice Location

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