MEDICARE: ARLINGTON MEDICAL CLINIC PC

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	29373	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

General Provider Information

NPI Number	:	1770510687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON MEDICAL CLINIC PC

Provider Business Mailing Address
First Line	:	11121 HIGHWAY 70
Second Line	:	SUITE 101
City	:	ARLINGTON
State	:	TN
Zip	:	38002-9754
Country	:	US
Telephone Number	:	901-867-0211
Fax Number	:	901-867-0759

Provider Business Practice Location Address
First Line	:	11121 HIGHWAY 70
Second Line	:	SUITE 101
City	:	ARLINGTON
State	:	TN
Zip	:	38002-9754
Country	:	US
Telephone Number	:	901-867-0211
Fax Number	:	901-867-0759

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HENRY ENYENIHI
Credential	:	MD
Telephone Number	:	901-867-0211

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	05/21/2008

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