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NPI Code Detail

MEDICARE: PARIS HENRY COUNTY CLINIC, S.C.

MEDICARE: PARIS HENRY COUNTY CLINIC, S.C.
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
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician
3363LF0000XFamily Nurse Practitioner0000005352TN
4208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396709283
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARIS HENRY COUNTY CLINIC, S.C.
Provider Business Mailing Address
First Line : 305 TYSON AVE
Second Line :
City : PARIS
State : TN
Zip : 38242-4579
Country : US
Telephone Number : 731-642-0025
Fax Number : 731-644-0899
Provider Business Practice Location Address
First Line : 305 TYSON AVE
Second Line :
City : PARIS
State : TN
Zip : 38242-4579
Country : US
Telephone Number : 731-642-0025
Fax Number : 731-644-0899
Authorized Official
Title or Position : ASSISTANT BUSINESS MANAGER
Name : MRS. SUSAN STUBBLEFIELD
Credential :
Telephone Number : 731-642-0025
Provider Enumeration Date : 04/17/2006
Last Update Date : 09/12/2008

Similar Medicare Providers

1780665919 — LYNN ELLEN DICUS FNP
Practice Location Address:
305 TYSON AVE
PARIS, TN
38242-4579
Practice Phone: 731-642-0025
Practice Fax: 731-644-0899
1063494193 — DR. TERRY OLEAN HARRISON M.D.
Practice Location Address:
305 TYSON AVE
PARIS, TN
38242-4579
Practice Phone: 731-642-0025
Practice Fax: 731-644-0899
1528040672 — CHARLES BURKHEAD HERRON M.D.
Practice Location Address:
305 TYSON AVE
PARIS, TN
38242-4579
Practice Phone: 731-642-0025
Practice Fax: 731-644-0899
1750363818 — VINCE CHARLES TUSA M.D.
Practice Location Address:
305 TYSON AVE
PARIS, TN
38242-4579
Practice Phone: 731-642-0025
Practice Fax: 731-644-0899
1770565459 — ANDREW CLARK COLEMAN M.D.
Practice Location Address:
305 TYSON AVE
PARIS, TN
38242-4579
Practice Phone: 731-642-0025
Practice Fax: 731-644-0899
1801878590 — JAMES HERVEY HUDSON M.D.
Practice Location Address:
305 TYSON AVE
PARIS, TN
38242-4579
Practice Phone: 731-642-0025
Practice Fax: 731-644-0899

Directions to “PARIS HENRY COUNTY CLINIC, S.C. ” Practice Location

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