MEDICARE: NEW HORIZON MEDICAL 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
1	208D00000X	General Practice Physician	35420	TN
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	37386	TN

General Provider Information

NPI Number	:	1578954350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZON MEDICAL PLLC

Provider Business Mailing Address
First Line	:	1292 1ST AVE
Second Line	:
City	:	LAWRENCEBURG
State	:	TN
Zip	:	38464-2762
Country	:	US
Telephone Number	:	931-244-7461
Fax Number	:

Provider Business Practice Location Address
First Line	:	1292 1ST AVE
Second Line	:
City	:	LAWRENCEBURG
State	:	TN
Zip	:	38464-2762
Country	:	US
Telephone Number	:	931-244-7461
Fax Number	:

Authorized Official
Title or Position	:	CO-MANAGER
Name	:	ELAINA MANUELE
Credential	:
Telephone Number	:	662-417-5475

Provider Enumeration Date	:	02/14/2015
Last Update Date	:	02/20/2015

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