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NPI Code Detail

MEDICARE: SATELLITE MED, PLLC

MEDICARE: SATELLITE MED, 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
1207Q00000XFamily Medicine Physician
2261QU0200XUrgent Care Clinic/CenterTN

General Provider Information

NPI Number : 1861515397
Entity Type Code : Organization
Provider Name (Legal Business Name) : SATELLITE MED, PLLC
Provider Business Mailing Address
First Line : 1120 SAMS ST
Second Line :
City : COOKEVILLE
State : TN
Zip : 38506-4006
Country : US
Telephone Number : 931-528-7312
Fax Number :
Provider Business Practice Location Address
First Line : 1120 SAMS ST
Second Line :
City : COOKEVILLE
State : TN
Zip : 38506-4006
Country : US
Telephone Number : 931-528-7312
Fax Number :
Authorized Official
Title or Position : COO
Name : SEAN VAN KERKHOVE
Credential :
Telephone Number : 615-975-8613
Provider Enumeration Date : 04/09/2007
Last Update Date : 06/24/2025

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Directions to “SATELLITE MED, PLLC ” Practice Location

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